The economic burden of non-communicable disease mortality in the South Pacific: Evidence from Fiji

Shamal Shivneel Chand; Baljeet Singh; Sanjesh Kumar

doi:10.1371/journal.pone.0236068

Peer Review History

Original SubmissionApril 12, 2020
20 May 2020 Decision Letter - Gausal A Khan, Editor PONE-D-20-10474 Non-Communicable disease mortality in Small Pacific Island Countries: Estimating the loss of human capital resource PLOS ONE Dear Dr. Singh, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. We would appreciate receiving your revised manuscript by Jul 04 2020 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'. Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out. We look forward to receiving your revised manuscript. Kind regards, Gausal A Khan, Ph.D Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. Please ensure you have thoroughly discussed any potential limitations of this study within the Discussion section. Additional Editor Comments (if provided): Dear Author. Please go though the reviewers comments and point-to-point reply will submit for further evaluation. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: No ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: No Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Results have to organised in a better way and figures should be more presentable. Discussion should be brief and to the point. Conclusion does not reflect discussion, it should be rewritten. Some of the references are not organised properly. Reviewer #2: Health economics is a growing field that push the universal health coverage agenda forward for improving health coverage, expanding services, and providing financial-risk protection are all necessary to optimize the population health. Chronic non-communicable disease (NCD) is the big issue in low and middle income countries which really need to focus on the building health systems that integrate complex, multidisciplinary interventions to reduce the economical burden. This study is focused on estimate the net percentage value loss of non-health GDP, and indirect cost of Non-communicable disease related mortality among the working age group of eight small Pacific Island countries (PIC) in 2017.Using human capital approach methodology with non-health GDP per capita, author emphasize that NCD related premature death in working age population creates a potential economical burden for the PICs. In most of the countries, the premature mortality due to cardiovascular disease and in working ages from 15 until the retirement age. Also, this study has recommended intervention to reduce the prevalence of NCD related that all small PICs should reduce the prevalence of NCD related premature death. This manuscript well written and describe the economical burden for the small Pacific Islands countries and also the interventions to reduce. The following comments should be resolved: (1) Which statistical analysis was used in this study to claim that NCD-related death in the working age group create a significant economic burden in the PIC? (2) Figure 1, bar diagram shows that percentage of total death is increased in NCD group in different group, but it is not clear that it is significant or not as no statistical analysis was shown. (3) Same in case of figure 3. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. 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Revision 1
18 Jun 2020 Author Response Response to Reviewers Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly Reviewer #2: Yes Response: We have revised the methodology and the methods used that are technically sound. We have used the Autoregressive Distributed Lag (ARDL) bounds test to cointegration approach to draw our conclusion. We have used official secondary data which is compiled by Ministry of Health, Fiji and the World Health Organization. Sample used is appropriate and bounds test to cointegration is standard procedure used to analyse time series data. Revised manuscript is based on Fiji as there no data available for other Pacific Island countries. Revised manuscript is based on long time series data which is only available for Fiji. ________________________________________ 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: N/A Reviewer #2: No Response: We have revised the methodology. We have used bounds test to cointegration approach. One of the advantages of the ARDL model is that it is very flexible where variables of both I(0) and I(1) status can be used to test for a cointegrating relationship. Secondly, the ARDL approach is an advantage to studies using a small sample size for estimation and forecasting [29]. Thirdly, the ARDL approach gives a consistent and unbiased estimate of the long-run parameters and each variable can have their own different lag-lengths compared to conventional cointegration tests. The fourth advantage of the ARDL approach is that it adequately deals with the problems of autocorrelation and endogeneity and provides unbiased and super-consistent coefficients with valid t-statistics. In sum, there are two steps involved in the ARDL bounds test approach to cointegration. We performed a number of robustness test and found our result is consistent. We carried out several diagnostic test and our result suffice all classical assumption. ________________________________________ 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: No Reviewer #2: Yes Response: We have uploaded all the data used in the analysis. ________________________________________ 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes Response: Manuscript presented and written in standard English. ________________________________________ 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Results have to organised in a better way and figures should be more presentable. Discussion should be brief and to the point. Conclusion does not reflect discussion, it should be rewritten. Some of the references are not organised properly. Response: We have rewritten all our results and discussion. Now it is more presentable, clear and easy to follow. We have rewritten our conclusion and policy implications and now it reflects the findings and discussion. Reviewer #2: Health economics is a growing field that push the universal health coverage agenda forward for improving health coverage, expanding services, and providing financial-risk protection are all necessary to optimize the population health. Chronic non-communicable disease (NCD) is the big issue in low and middle income countries which really need to focus on the building health systems that integrate complex, multidisciplinary interventions to reduce the economical burden. This study is focused on estimate the net percentage value loss of non-health GDP, and indirect cost of Non-communicable disease related mortality among the working age group of eight small Pacific Island countries (PIC) in 2017.Using human capital approach methodology with non-health GDP per capita, author emphasize that NCD related premature death in working age population creates a potential economical burden for the PICs. In most of the countries, the premature mortality due to cardiovascular disease and in working ages from 15 until the retirement age. Also, this study has recommended intervention to reduce the prevalence of NCD related that all small PICs should reduce the prevalence of NCD related premature death. This manuscript well written and describe the economical burden for the small Pacific Islands countries and also the interventions to reduce. The following comments should be resolved: (1) Which statistical analysis was used in this study to claim that NCD-related death in the working age group create a significant economic burden in the PIC? Response: Our revised manuscript is extensively rewritten based on the comments and suggestion of two reviewers. In the revised manuscript, we have used bounds test to cointegration approach, it is standard procedure used to analyse factors affecting economic output. We carried out a several robustness test and find out result is consistent. Revised manuscript is based on Fiji as there no data available for other Pacific Island countries. Revised manuscript is based on long time series data which is only available for Fiji. (2) Figure 1, bar diagram shows that percentage of total death is increased in NCD group in different group, but it is not clear that it is significant or not as no statistical analysis was shown. Response: All results and graph figures are revised based on our revised findings. We have used ARDL bounds test to analyse our data. We carried out a number of diagnostic test and find our result is reliable. (3) Same in case of figure 3. Response: All our analysis is based on ARDL bounds testing technique. However, this comment is no longer relevant in revised manuscript. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0236068.r002
29 Jun 2020 Decision Letter - Gausal A Khan, Editor The economic burden of non-communicable disease mortality in the South Pacific: Evidence from Fiji PONE-D-20-10474R1 Dear Dr. Singh, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Gausal A Khan, Ph.D Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #2: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The authors responded to the comments made by the reviewer. The results should be described in the simplified manner. Reference need to be corrected. Reviewer #2: This study is interesting and valuable regarding the economic burden and non-communicable disease mortality in the south Pacific, especially Fiji. The revised manuscript described well about the methods and statistical analysis based on comments and explains the analysis of the data. I am fully recommending this revised manuscript for publication. I hope, this publication opens a new sight to think about the economic burden and non-communicable related mortality rate in other countries. ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No https://doi.org/10.1371/journal.pone.0236068.r003
Formally Accepted
6 Jul 2020 Acceptance Letter - Gausal A Khan, Editor PONE-D-20-10474R1 The economic burden of non-communicable disease mortality in the South Pacific: Evidence from Fiji Dear Dr. Singh: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Gausal A Khan Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0236068.r004

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