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Research Article
Revised

The National Heart, Lung, and Blood Institute data: analyzing published articles that used BioLINCC open access data

[version 4; peer review: 2 approved, 1 approved with reservations, 1 not approved]
Previously titled: "The impact of the National Heart, Lung, and Blood Institute data: analyzing published articles that used BioLINCC open access data"
PUBLISHED 18 Aug 2021
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OPEN PEER REVIEW
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This article is included in the Research on Research, Policy & Culture gateway.

Abstract

Background: Data sharing is now a mandatory prerequisite for several major funders and journals, where researchers are obligated to deposit the data resulting from their studies in an openly accessible repository. Biomedical open data are now widely available in almost all disciplines, where researchers can freely access and reuse these data in new studies. We aim to study the BioLINCC datasets, number of publications that used BioLINCC open access data, and the citations received by these publications.
Methods: As of July 2019, there was a total of 194 datasets stored in BioLINCC repository and accessible through their portal. We requested the full list of publications that used these datasets from BioLINCC, and we also performed a supplementary PubMed search for other publications. We used Web of Science (WoS) to analyze the characteristics of publications and the citations they received, where WoS database index high quality articles.
Results: 1,086 published articles used data from BioLINCC repository for 79 (40.72%) datasets, where 115 (59.28%) datasets did not have any publications associated with it. Of the total publications, 987 (90.88%) articles were WoS indexed. The number of publications has steadily increased since 2002 and peaked in 2018 with a total number of 138 publications on that year. The 987 open data publications (i.e., secondary publications) received a total of 34,181 citations up to 1 st October 2019. The average citation per item for the open data publications was 34.63. The total number of citations received by open data publications per year has increased from only 2 citations in 2002, peaking in 2018 with 2361 citations.
Conclusion: Majority of BioLINCC datasets were not used in secondary publications. Despite that, the datasets used for secondary publications yielded publications in WoS indexed journals and are receiving an increasing number of citations.

Keywords

Open Data, Publications, National Institute of Health, Bibliometrics

Revised Amendments from Version 3

The reviewers, again, performed an in-depth assessment and provided valuable points to be amended and improved, which we followed point by point. We performed editions on figure 1, where we corrected the text within the figure as suggested by reviewers. They also suggested improvements in the dataset. In this regard, we uploaded a separate codebook to detail the dataset details. We hope the manuscript in its current improved version satisfies, to a certain degree, their expectations.

See the authors' detailed response to the review by Lisa Federer
See the authors' detailed response to the review by Colby Vorland and Andrew Brown
See the authors' detailed response to the review by Christian Ohmann

Introduction

Recent years have seen an increased call for data sharing in clinical studies, especially for research funded by international and governmental agencies1. The call originally aimed to maximize transparency for clinical trial results1, but the benefits of data sharing extended beyond its original aim. Open access data is frequently cited as a boon for researchers, where researchers can re-analyze already collected data to answer a new research question2,3. To organize and maximize the scientific use of open access data, researchers and funders store their data in open access data repositories4. The Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC), is a National Heart, Lung, and Blood Institute is one such data repository, initiated in 2000 with the aim of sharing data from observational and interventional studies supported by the institute5. The impact of open access data, in terms of number of datasets used from a repository, publications generated from these datasets, and citations received by these publications are still unknown. In this study, we aim to study the BioLINCC datasets, number of publications that used BioLINCC open access data, and the citations received by these publications.

Methods

Data collection

There are a total of 205 studies listed on BioLINCC data repository, where four studies have their data stored in other repositories, and seven studies have only specimens available at the BioLINCC institution available upon request, but no datasets associated with them. We only included datasets stored in BioLINCC repository and can be accessed through their portal, which comprises 194 datasets. (Figure 1).

34bf10d5-1389-41b8-ac7b-94ba7b2b7bde_figure1.gif

Figure 1. The initial datasets and the final datasets included after applying exclusion criteria.

We also contacted BioLINCC support to obtain an up to date list of published articles that used BioLINCC datasets, where we received a list of all publications up to 24th July 2019. This list might not reflect the total publications of 2019, as the whole year was not included. Researchers accessing the BioLINCC datasets are requested to disclose any publication resulted from the use of the BioLINCC datasets. The BioLINCC also list published articles that used BioLINCC datasets on their website (https://biolincc.nhlbi.nih.gov/publications/). A manual search of PubMed was also carried out on 25th of July 2019 to confirm an updated full list of publications, as follows:

  • We used the basic search of PubMed by inputting the title of the dataset in the search field (e.g., Cooperative Study of Sickle Cell Disease or CSSCD), in order to retrieve results that mention the dataset in the title, abstract, or keywords. It is important to note here that each dataset available on the BioLINCC repository had its own acronym.

  • The searched articles were manually screened by one of the authors (SAA) to check if the dataset was used in the study to generate results, where authors either detail the name and acronym of dataset used in the methods section, usually with specific citation to relevant study, or in the acknowledgment section in their articles. The included articles either used data stored in the BioLINCC repository alone or used these datasets along with other datasets from other repositories

  • We added the searched articles to the original dataset provided by the BioLINCC.

  • We analyzed the number of studies published using each dataset (supplementary material).

Bibliometric analysis

We used Web of Science (WoS) database to analyze the characteristics of included publications. We prepared a list of digital object identifiers (DOIs) for the included articles. We inputted the DOI list into the WoS advanced search field, where only WoS indexed publications from the total included articles were analyzed further. The WoS database has a built-in analysis to provide data regarding the number of publications using the included dataset per year (yearly publications), topic of publication, affiliation of authors, and number of citations received6.

Results

1,086 published articles used data from BioLINCC repository for 79 (40.72%) datasets, where 115 (59.28%) datasets did not have any publications associated with it. Dataset for the Atherosclerosis Risk in Communities Study (ARIC) had the highest number of publications associated with it 162 (15%), followed by Framingham Heart Study-Cohort (FHS-Cohort) with 94 (8.7%), and Cardiovascular Health Study (CHS) with 82 (7.6%). 162 (14.9%) of publications used more than one dataset (Table 1). Out of the 1,086 published articles, only 987 (90.88%) articles were WoS indexed. All articles published were English language (see underlying data7). The first publication using BioLINCC open data (i.e., secondary publication) was from 2002. Since then, the number of publications has steadily increased since 2002, as shown in Figure 2, and peaked in 2018 with a total number of 138 publications. For the 99 (9.12%) articles that were not indexed, they were distributed over the years with the majority (i.e. 42 articles) published in 2018.

Table 1. Top 10 datasets in the Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) with highest number of publications.

Dataset Count%
Atherosclerosis Risk in Communities Study 16215.0%
Framingham Heart Study-Cohort 948.7%
Cardiovascular Health Study (CHS) 827.6%
Digitalis Investigation Group 767.0%
Framingham Heart Study (FHS) Offspring (OS) and OMNI 1
Cohorts
534.9%
Action to Control Cardiovascular Risk in Diabetes 464.3%
Systolic Blood Pressure Intervention Trial 444.1%
Evaluation Study of Congestive Heart Failure and
Pulmonary Artery Catheterization Effectiveness
393.6%
Coronary Artery Risk Development in Young Adults 383.5%
Atrial Fibrillation Follow-Up Investigation of Rhythm
Management
333.1%
34bf10d5-1389-41b8-ac7b-94ba7b2b7bde_figure2.gif

Figure 2. Number of publications that used Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) open data since 2002.

The 987 open data publications received a total of 34,181 citations from 27,904 published articles up to 1st October 2019. The average citation per item for the publications using BioLINCC data was 34.63. The total number of citations received by publications using BioLINCC data per year has increased from only 2 citations in 2002, to a peak of 4361 citations in 2018 (Figure 3).

34bf10d5-1389-41b8-ac7b-94ba7b2b7bde_figure3.gif

Figure 3. The total number of citations received by open data publications per year.

A total of 352 (35.66%) of the published articles related to cardiac and cardiovascular systems, 106 (10.74%) articles related to general internal medicine, and 92 (9.32%) related to public and occupational health. Figure 4 shows the 10 most common fields the studied publications using BioLINCC data published in. The American Journal of Cardiology had the highest number of publications using BioLINCC data (60; 6.08%), followed by the International Journal of Cardiology with 47 (4.76%), and American Journal of Medicine 25 (2.53%). Table 2 shows the top 10 journals that publications using BioLINCC data were published in. US authors participated in 842 (85.31%) of the publications using BioLINCC data, followed by Canadian and English authors, with 121 (12.26%), and 81 (8.21%), respectively (Figure 5). The top three affiliations in terms of publications using BioLINCC data were University of Alabama at Birmingham, University of California system, and Harvard University as shown in Table 3.

34bf10d5-1389-41b8-ac7b-94ba7b2b7bde_figure4.gif

Figure 4. The 10 most common fields the studied open data articles published in.

Table 2. Top 10 journals publishing articles that used Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) open data with their respective impact factor according to 2018 Journal Citation report.

JOURNAL Impact
factor
Articles (%)
AMERICAN JOURNAL OF CARDIOLOGY 2.84360 (6.08%)
INTERNATIONAL JOURNAL OF CARDIOLOGY 3.47147 (4.76%)
AMERICAN JOURNAL OF MEDICINE 4.76025 (2.53%)
EUROPEAN JOURNAL OF HEART FAILURE 12.12922 (2.23%)
HYPERTENSION 7.01722 (2.23%)
PLOS ONE 2.77621 (2.13%)
CIRCULATION 23.05418 (1.82%)
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 18.63918 (1.82%)
JOURNAL OF CARDIAC FAILURE 3.96716 (1.62%)
EUROPEAN HEART JOURNAL 24.88915 (1.52%)
34bf10d5-1389-41b8-ac7b-94ba7b2b7bde_figure5.gif

Figure 5. The top countries published using Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) open data.

Table 3. The top affiliations in terms of open data publications using Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) open data.

OrganizationArticlesPercentage
UNIVERSITY OF ALABAMA BIRMINGHAM 24024.316%
UNIVERSITY OF CALIFORNIA SYSTEM 10911.044%
HARVARD UNIVERSITY 10510.638%
UNIVERSITY OF CALIFORNIA SAN FRANCISCO 575.775%
CASE WESTERN RESERVE UNIVERSITY 555.572%
VETERANS HEALTH ADMINISTRATION VHA 545.471%
UNIVERSITY OF CALIFORNIA LOS ANGELES 535.370%
UNIVERSITY OF TEXAS SYSTEM 525.268%
PENNSYLVANIA COMMONWEALTH SYSTEM OF HIGHER EDUCATION PCSHE 515.167%

Discussion

Tremendous effort has been made by BioLINCC in preparing dataset to be used as open data since its establishment, where hundreds of studies have been published using BioLINCC open data6. Despite the finding that majority of datasets did not yield further publications from the re-use of the dataset, many of the datasets had high number of publications. The citations of publications using BioLINCC data have dramatically increased. They received a total of 2361 citations in the year 2018. Cardiology is the main field, with more than third of publications are cardiology related, which is expected, as the dataset are related to heart, lung, blood institute. The top two journals publishing articles using BioLINCC data are also cardiology journals.

In an analysis done in 2017, Coady and his colleagues analyzed the administrative records of investigator requests for BioLINCC data, they found that 35% of clinical trial data were associated with at least one publication within five years from data public release8. Our findings also showed that majority of datasets deposited in the BioLINCC repository were not associated with secondary publications. In a previous survey conducted on researchers who requested datasets from BioLINCC showed that the majority of researchers requested the data to conduct an independent research project8. Moreover, Ross et al. in their survey also found that majority of requests to the BioLINCC repository were made by early career researchers. Where we previously pointed to the importance of open access data for underfunded and early career researchers2, our results showed that the top users of open access data were from developed countries. This might be related to the fact that the data deposited and made open are from USA. Research studies performed using open access data might have important impact, an example would be the post-hoc analysis of the Digitalis Investigation Group trial using the open data of the original trial9, which showed that digoxin therapy is associated with an increased risk of death from any cause among women, but not men, a finding that the original study failed to find. The digitalis trial is an example of how cardiology researchers are using open data, with efforts of cardiology initiatives encouraging data sharing and use by cardiology researchers10. Clinical trial data sharing in cardiology has also been used to validate the reproducibility of published results11. The high number of citations received publications using the BioLINCC shared datasets might be related to the regulations of National Institute of Health, which mandated that data collected by studies receiving more than $500,000 be stored in a publicly available repository, with BioLINCC being the main repository for The National Institute of Health - The National Heart, Lung, and Blood Institute (NIH-NHLB) institute funded research12. On the other hand, data shared by platforms other than BioLINCC may lack sufficient description about the shared data, which will hamper its use by other researchers13. Upon interpreting the results of the current study, several limitations need to be considered. Our results are based on BioLINCC repository, where data of well-funded research projects undergo extensive processing before being publicly shared, resulting in well-curated, high quality data. Other studies should be done to evaluate data repositories that do not have the pre-sharing processing. Another point here is that we used the WoS database for data extraction and analysis, which might not include several studies done using open access data from the BioLINCC repository. The WoS database usually requires time to index newly accepted articles, which might lead to underestimation in the number WoS indexed articles. Moreover, we did not compare citations received by open data publications and primary data publications, which should be carried out in future projects. One key point that may undermine the idea of ‘impact’ of the open datasets is that the study investigators appear to be included in these counts. For example, the University of Alabama at Birmingham is a key site for some studies (e.g., CARDIA), and thus they would be publishing from their datasets whether they were open in BioLINCC or not, so this need to be considered upon interpreting the results. Finally, using citation as the sole metric for impact is a debatable issue, but it can be better used as a metric for attention.

Data availability

Underlying data

Harvard Dataverse: Publications that used Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) datasets. https://doi.org/10.7910/DVN/1TXA3C7

This project contains the following underlying data:

  • BioLINCC Dataset.tab (Spreadsheet containing details of publications using BioLINCC datasets)

Data are available under the terms of the Creative Commons Zero “No rights reserved” data waiver (CC0 1.0 Public domain dedication).

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AlRyalat SA, El Khatib O, Al-qawasmi O et al. The National Heart, Lung, and Blood Institute data: analyzing published articles that used BioLINCC open access data [version 4; peer review: 2 approved, 1 approved with reservations, 1 not approved]. F1000Research 2021, 9:30 (https://doi.org/10.12688/f1000research.21884.4)
NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article.
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ApprovedThe paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approvedFundamental flaws in the paper seriously undermine the findings and conclusions
Version 4
VERSION 4
PUBLISHED 18 Aug 2021
Revised
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Reviewer Report 16 Sep 2021
Heyam F Dalky, College of Nursing, Community and Mental Health Nursing Department, Jordan University of Science and Technology, Irbid, Jordan 
Approved
VIEWS 19
This is an interesting paper about the impact of data sharing using a non-Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) .

The authors in this manuscript analyzed previous published reports/studies that used the BioLINCC openly ... Continue reading
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Dalky HF. Reviewer Report For: The National Heart, Lung, and Blood Institute data: analyzing published articles that used BioLINCC open access data [version 4; peer review: 2 approved, 1 approved with reservations, 1 not approved]. F1000Research 2021, 9:30 (https://doi.org/10.5256/f1000research.76584.r94247)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Reviewer Report 15 Sep 2021
Andrew Brown, Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA 
Colby Vorland, Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA 
Not Approved
VIEWS 13
We thank the authors for revising their submission, but unfortunately concerns remain.

The searching and screening processes are still not reproducible by readers.
  • The search remains unclear. For example, if one enters their
... Continue reading
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Brown A and Vorland C. Reviewer Report For: The National Heart, Lung, and Blood Institute data: analyzing published articles that used BioLINCC open access data [version 4; peer review: 2 approved, 1 approved with reservations, 1 not approved]. F1000Research 2021, 9:30 (https://doi.org/10.5256/f1000research.76584.r92162)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
Version 3
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PUBLISHED 21 Apr 2021
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Reviewer Report 26 May 2021
Colby Vorland, Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA 
Andrew Brown, Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA 
Not Approved
VIEWS 26
We thank the authors for responding to our comments. We still have several outstanding concerns.

Specifically, we thank the authors for clarifying about the 9% of articles not indexed in WoS. Publishing the full results of the ... Continue reading
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Vorland C and Brown A. Reviewer Report For: The National Heart, Lung, and Blood Institute data: analyzing published articles that used BioLINCC open access data [version 4; peer review: 2 approved, 1 approved with reservations, 1 not approved]. F1000Research 2021, 9:30 (https://doi.org/10.5256/f1000research.56007.r83686)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
  • Author Response 18 Aug 2021
    Saif Aldeen AlRyalat, Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan
    18 Aug 2021
    Author Response
    The reviewers again performed an in-depth assessment and provided valuable points to be amended and improved, which we followed point by point. They also suggested improvements in the dataset. In ... Continue reading
COMMENTS ON THIS REPORT
  • Author Response 18 Aug 2021
    Saif Aldeen AlRyalat, Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan
    18 Aug 2021
    Author Response
    The reviewers again performed an in-depth assessment and provided valuable points to be amended and improved, which we followed point by point. They also suggested improvements in the dataset. In ... Continue reading
Version 2
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PUBLISHED 28 Sep 2020
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Reviewer Report 19 Oct 2020
Lisa Federer, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA 
Approved
VIEWS 18
I appreciate ... Continue reading
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Federer L. Reviewer Report For: The National Heart, Lung, and Blood Institute data: analyzing published articles that used BioLINCC open access data [version 4; peer review: 2 approved, 1 approved with reservations, 1 not approved]. F1000Research 2021, 9:30 (https://doi.org/10.5256/f1000research.29748.r72105)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
Version 1
VERSION 1
PUBLISHED 20 Jan 2020
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Reviewer Report 25 Sep 2020
Colby Vorland, Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA 
Andrew Brown, Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA 
Not Approved
VIEWS 30
Summary:
The authors ask an interesting question as to what the impact of BioLINCC has been on the use of open data. However, the assessments of impact do not seem to appropriately contextualize the use of BioLINCC datasets as ... Continue reading
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Vorland C and Brown A. Reviewer Report For: The National Heart, Lung, and Blood Institute data: analyzing published articles that used BioLINCC open access data [version 4; peer review: 2 approved, 1 approved with reservations, 1 not approved]. F1000Research 2021, 9:30 (https://doi.org/10.5256/f1000research.24126.r70340)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
  • Author Response 21 Apr 2021
    Saif Aldeen AlRyalat, Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan
    21 Apr 2021
    Author Response
    I went through the manuscript and amended and responded to all comments. Here are the responses.

    Reviewer Colby Vorland and Andrew Brown



    It is an honor ... Continue reading
COMMENTS ON THIS REPORT
  • Author Response 21 Apr 2021
    Saif Aldeen AlRyalat, Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan
    21 Apr 2021
    Author Response
    I went through the manuscript and amended and responded to all comments. Here are the responses.

    Reviewer Colby Vorland and Andrew Brown



    It is an honor ... Continue reading
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36
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Reviewer Report 08 Sep 2020
Lisa Federer, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA 
Not Approved
VIEWS 36
The authors have addressed an interesting question - what are the impacts of open data, specifically considering citations received by publications using open data sets. This question is very timely given the increasing number of funder and journal requirements that ... Continue reading
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CITE
HOW TO CITE THIS REPORT
Federer L. Reviewer Report For: The National Heart, Lung, and Blood Institute data: analyzing published articles that used BioLINCC open access data [version 4; peer review: 2 approved, 1 approved with reservations, 1 not approved]. F1000Research 2021, 9:30 (https://doi.org/10.5256/f1000research.24126.r70339)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
  • Author Response 28 Sep 2020
    Saif Aldeen AlRyalat, Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan
    28 Sep 2020
    Author Response
    We would like to thank Dr. Frederer, who is an expert in the field of data science, for the insight and thoughts she shared through her revision. While we agree with her ... Continue reading
COMMENTS ON THIS REPORT
  • Author Response 28 Sep 2020
    Saif Aldeen AlRyalat, Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan
    28 Sep 2020
    Author Response
    We would like to thank Dr. Frederer, who is an expert in the field of data science, for the insight and thoughts she shared through her revision. While we agree with her ... Continue reading
Views
40
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Reviewer Report 10 Aug 2020
Christian Ohmann, European Clinical Research Infrastructure Network, ECRIN, Düsseldorf, Nordrhine-Westfalia, Germany 
Approved with Reservations
VIEWS 40
This is an interesting paper about the impact of data sharing for a non-commercial repository (BioLINCC). From the viewpoint of the reviewer, the manuscript should be improved:

In the section “data collection” the authors describe different data ... Continue reading
CITE
CITE
HOW TO CITE THIS REPORT
Ohmann C. Reviewer Report For: The National Heart, Lung, and Blood Institute data: analyzing published articles that used BioLINCC open access data [version 4; peer review: 2 approved, 1 approved with reservations, 1 not approved]. F1000Research 2021, 9:30 (https://doi.org/10.5256/f1000research.24126.r68865)
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
  • Author Response 28 Sep 2020
    Saif Aldeen AlRyalat, Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan
    28 Sep 2020
    Author Response
    It is an honor to receive feedback from professor Ohmann, we performed almost all the changes suggested, and we hope the current version satisfies the quality required. Here are the ... Continue reading
  • Author Response 21 Apr 2021
    Saif Aldeen AlRyalat, Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan
    21 Apr 2021
    Author Response
    Dear Professor Ohmann,

    We hope our responses satisfy your comments, if so, we hope to receive your feedback. 

    Thank you for your time.

    Sincerely,
    Saif Aldeen AlRyalat, MD.
    ... Continue reading
COMMENTS ON THIS REPORT
  • Author Response 28 Sep 2020
    Saif Aldeen AlRyalat, Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan
    28 Sep 2020
    Author Response
    It is an honor to receive feedback from professor Ohmann, we performed almost all the changes suggested, and we hope the current version satisfies the quality required. Here are the ... Continue reading
  • Author Response 21 Apr 2021
    Saif Aldeen AlRyalat, Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan
    21 Apr 2021
    Author Response
    Dear Professor Ohmann,

    We hope our responses satisfy your comments, if so, we hope to receive your feedback. 

    Thank you for your time.

    Sincerely,
    Saif Aldeen AlRyalat, MD.
    ... Continue reading

Comments on this article Comments (0)

Version 4
VERSION 4 PUBLISHED 20 Jan 2020
Comment
Alongside their report, reviewers assign a status to the article:
Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions
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