Reviews for Assistive technology access in longitudinal datasets: a global review
By Jamie Danemayer, Sophie Mitra, Cathy Holloway and Shereen Hussein
Article as submitted
Article Authors
Submission Date: 02/08/2022
Round 1 Reviews
Reviewer A
Anonymous Reviewer
Completed 10/10/2022
https://doi.org/10.23889/ijpds.v8i1.1901.review.r1.reviewa
The authors are to be congratulated for a manuscript that provides a valuable contribution to the field of measuring and monitoring access to assistive technology. In general, the text is well-sctructured and clear. I have only some minor comments, which I hope will contribute to improving the quality.
Abstract
Replace "Functioning limitations" with "Functional limitations"
Replace ">40%" with "Over 40%" or similar.
Clarify what "pre-existing needs" means; needs for what?
The last sentence needs some attention. The evidence for and logic of "longitudinal analyses can should be undertaken ... to expand access to AT globally". First, the findings do not support the conslusion that longitudinal analayses can and should be undertaken. Second, it is not clear how analyses expand services; perhaps they can inform expansion plans?
Introduction
The aim sentence is not clear. Perhaps the ", that" can be replaced by "and". It is difficult to know what the last part - "to facilitate research on AT access globally" - relate to. Is it the collation of the datasets that will facilitate research? Or is it that only datasets with indicators that facilitate research on AT should be included?
In the definition of assistive technology, please use the full WHO definitions of AT and assistive products.
WHO is quite specific when it defines "access" and does not use it as an umbrella term for a range of indicators. Please define what you mean by "access" early in the Introduction.
The second lst sentence of the Introduction can be brought to the very beginning of the Methods section and the last sentence is largely repeated in Limitations. I would suggest that its content is included in the Discussion instead.
Methods
The text under Reviewing could be moved before Searching. You may consider restructuring the Methods section in this way:
- Eligibility criteria (What assistive products are covered, and inclusion and exclusion criteria for cohorts/surveys.)
- Search strategy (Currently Searching)
- Data extraction
The second paragraph lists one report (Fordham ... 2022) while the following sentence using "in each report" gives a sense that there were more reports. Please rephrase or clarify.
Results
The last part of the first sentence under "Cross-sectional surveys" is unclear.
Discussion
The first paragraph may reiterate the aim and main findings.
The second pararaph contains findings that are not reported in Results. Please add them to the Results section and use the Discussion to discuss them.
In the last sentence, assistive technology is spelled out although AT has been used earlier, also about the global report.
Limitations
Avoid the use of "extremely". (I know at least two longitudinal surveys that have not been captured by the sources although they fit the inclusion criteria.
Language
In the Results and Discussion, there are a few instances where "data" is followed by "was" or "is" instead of "were" or "are". In the Discussion, "data are can be" may better read "data can be".
Reccomendation: Revisions Required
Reviewer B
Anonymous Reviewer
Completed 07/10/2022
https://doi.org/10.23889/ijpds.v8i1.1901.review.r1.reviewb
Thank you for requesting me to review this submission.
This paper and especially the cohort studies and surveys listed are an important contribution to pointing researchers toward relevant data on assistive technology - something that is hard to come by. It provides a good basis and importantly also points to a database where updates will be possible.
Suggestions for minor corrections are included in the attached file.
Reccomendation: Revisions Required
Editor Decision
Claudia Medina Coeli
Decision Date: 01/11/2022
Decision: Resubmit for Review
https://doi.org/10.23889/ijpds.v8i1.1901.review.r1.dec
Dear Jamie Danemayer, Sophie Mitra, Cathy Holloway, Shereen Hussein:
We have reached a decision regarding your submission to International Journal of Population Data Science, "Assistive technology access in longitudinal datasets: A global review".
Please address the attached reviewers' comments and return to us: one clean and one tracked changes version of your revised manuscript, plus a point by point letter of response/rebuttal, by 30 November 2022.
Our decision is to: Resubmit for Review
Kind Regards
Author Response
Jamie Danemayer
Response Date: 05/12/2022
IJPDS Response to Reviewers
Thank you sincerely to both reviewers for their detailed and helpful comments. We have integrated many suggested changes to the best of our ability and documented all edits in our revised draft and our responses below. We hope these revisions and responses address all areas lacking clarity.
Reviewer A:
The authors are to be congratulated for a manuscript that provides a valuable contribution to the field of measuring and monitoring access to assistive technology. In general, the text is well-sctructured and clear.
We are grateful to the reviewers’ assessment.
I have only some minor comments, which I hope will contribute to improving the quality.
Abstract
- Replace "Functioning limitations" with "Functional limitations"
Done
- Replace ">40%" with "Over 40%" or similar.
Done
- Clarify what "pre-existing needs" means; needs for what?
We were limited for word count and used ‘needs’ as the most inclusive way to describe cohorts excluding individuals with limited independence, needing assistance or aides, and/or having pre-existing clinical conditions. We have changed this to say ‘support needs.’
- The last sentence needs some attention. The evidence for and logic of "longitudinal analyses can should be undertaken ... to expand access to AT globally". First, the findings do not support the conclusion that longitudinal analyses can and should be undertaken. Second, it is not clear how analyses expand services; perhaps they can inform expansion plans?
We have rewritten this sentence to align with the structure of our discussion and conclusion which directly flow from results, specifically that by collating what data are currently available, some analyses that could inform AT provision planning are possible, and we now also have on opportunities to improve data collection initially.
Introduction
- The aim sentence is not clear. Perhaps the ", that" can be replaced by "and". It is difficult to know what the last part - "to facilitate research on AT access globally" - relate to. Is it the collation of the datasets that will facilitate research? Or is it that only datasets with indicators that facilitate research on AT should be included?
We have updated this sentence for clarity, specifying that we do mean only longitudinal datasets with indicators on AT should be included and that it is the coalition of these data that will facilitate research.
- In the definition of assistive technology, please use the full WHO definitions of AT and assistive products.
We introduce the concept of assistive technology with the inclusive WHO definition. We also now make clear that our review focuses on assistive products specifically, and we link this with the WHO’s definition of priority assistive products.
- WHO is quite specific when it defines "access" and does not use it as an umbrella term for a range of indicators. Please define what you mean by "access" early in the Introduction.
We define access with the same indicators used by the WHO’s rapid assistive technology assessment survey. We now clarify this in our methods. We felt this is the most appropriate place to specify which data terms we were looking for specifically, as our definitions come from data sources that must first be introduced and explained.
- The second last sentence of the Introduction can be brought to the very beginning of the Methods section and the last sentence is largely repeated in Limitations. I would suggest that its content is included in the Discussion instead.
We have made the suggested changes to the introduction, methods, discussion, and limitations.
Methods
-
The text under Reviewing could be moved before Searching. You may consider restructuring the Methods section in this way:
- Eligibility criteria (What assistive products are covered, and inclusion and exclusion criteria for cohorts/surveys.)
- Search strategy (Currently Searching)
- Data extraction
We have made the suggested restructure.
- The second paragraph lists one report (Fordham ... 2022) while the following sentence using "in each report" gives a sense that there were more reports. Please rephrase or clarify.
We now specify the 2022 report as singular (it is an updated, more comprehensive counterpart to their initial report published the previous year).
Results
- The last part of the first sentence under "Cross-sectional surveys" is unclear.
We have reworded this sentence for clarity.
Discussion
- The first paragraph may reiterate the aim and main findings.
We have incorporated our aims into the introductory portion of our discussion.
- The second paragraph contains findings that are not reported in Results. Please add them to the Results section and use the Discussion to discuss them.
These results are available in the in-text tables. Results are also structured so written portions for cohorts and surveys align. Some results available in the tables are more relevant to one study design, so they merit discussion rather than particular mention in two results sections.
- In the last sentence, assistive technology is spelled out although AT has been used earlier, also about the global report.
We spell out assistive technology here because we are referencing the title of the world report. We again mention this report, and the world report on ageing, at the end of the discussion to bring up a new point, which is the role of these reports in informing policy and operational planning at national levels to conclude our discussion on the utility of these data.
Limitations
- Avoid the use of "extremely". (I know at least two longitudinal surveys that have not been captured by the sources although they fit the inclusion criteria.
We have edited this sentence accordingly. As our first priority is to create as exhaustive as possible a repository of data on AT, we would be grateful if these surveys could be shared with the authors as soon as anonymisation is no longer required.
- In the Results and Discussion, there are a few instances where "data" is followed by "was" or "is" instead of "were" or "are". In the Discussion, "data are can be" may better read "data can be".
Both sections have been reviewed and revised for this issue.
Reviewer B:
Thank you for your detailed read of our manuscript. You highlighted several grammatical errors/convoluted sentences, which we have edited in accordance in the manuscript rather than individually listing in this response.
Abstract
- Better data would at first only increase the knowledge base and allow for better planning with expanded access to AT a very distant and indirect impact. Instead of this sentence, I would suggest using a version of the Conclusion
We have now clarified that improved data supports efforts to expand access, rather than directly expanding access itself.
Introduction
- the link to AT use is not immediately clear
We do establish this link within the first paragraph. Overall, authors feel it necessary to first communicate the urgency of aging and healthy longevity before highlighting AT’s role, so that the importance of monitoring AT access at a population level is well-understood.
- “...potential to produce highly valuable, nuanced forecasts...” can this be expanded on or an example be provided?
We have clarified this sentence and specified these forecasts can be used for service provision planning.
Methods
- “For the purposes of this review, AT is defined using the WHO’s list of 50 PAPs...” can this be reworded slightly? this contradicts the earlier definition of AT as products AND services. also "can be indicated in parts" is a bit unclear - how is "needing" AT part of access to AT?
We added that we use this definition because in the authors’ experience, AT is typically represented in population-level data only in terms of devices. Services are also less well-defined overall.
Self-reported need for AT is often the closest approximation we can get to market-level demand for AT. Understanding need is essential to then differentiate between unmet and met need, which indicates where provision is in/effective, respectively. We have added this detail to our methods.
Results
- “...12 (12/15, 80%) exclude persons due to a pre-existing health limitation or diagnoses, and four (27%) exclude institutionalised persons, meaning those who are incarcerated or residing in long-term care facilities...” While I understand that in this part all results are listed without judgement and in the discussion section it is later indicated how this finding is problematic, I wonder whether there is any way of indicating this here already while staying within the realm of what is allowed in academic discourse?
We agree this is a salient point, however, we also feel it wasn’t fully appropriate to indicate that in the Results and instead we tried to highlight it in the Discussion.
Discussion:
- “...12 (12/15, 80%) exclude persons due to a pre-existing health limitation or diagnoses, and four (27%) exclude institutionalised persons, meaning those who are incarcerated or residing in long-term care facilities...” While I understand that in this part all results are listed without judgement and in the discussion section it is later indicated how this finding is problematic, I wonder whether there is any way of indicating this here already while staying within the realm of what is allowed in academic discourse?
This comment is connected to a discussion sentence about cohorts, however the translations we acknowledged were needed for cross-sectional questionnaires only (there were questionnaires in French but as the primary author speaks French, no acknowledgement was needed for that specific language translation). All cross-sectional data were taken from a globally-focused initiative that reviewed census/DHS questionnaires from every country in the world, and targeted country searching was done when questionnaires were unavailable in traditional DHS databases, specifically to fill the gap you mentioned. We describe this in our Methods and link to the comprehensive search details provided by this initiative.
All cohort data utilised in this review (characteristics, criteria, waves, etc) were available in English, in the database/repository used to identify them. This repository seeks and includes cohorts globally, including those with non-English datasets, and due to the scope of the repository, targeted searching for cohort studies in other languages would likely be ineffective as well as time burdensome.
Round 2 Reviews
Reviewer B
Anonymous Reviewer
Completed 15/12/2022
https://doi.org/10.23889/ijpds.v8i1.1901.review.r2.reviewb
I appreciate the time taken to address all comments from the previous stage and the explanations given in the rebuttal. I have no further comments.
Reccomendation: Accept Submission
Editor Decision
Claudia Medina Coeli
Decision Date: 14/12/2022
Decision: Resubmit for Review
https://doi.org/10.23889/ijpds.v8i1.1901.review.r2.dec
Dear Jamie Danemayer, Sophie Mitra, Cathy Holloway, Shereen Hussein:
We have reached a decision regarding your submission to International Journal of Population Data Science, "Assistive technology access in longitudinal datasets: A global review", and are delighted to inform you that our decision is to: Accept Submission.
We look forward to working with you through the next stages towards final publication.
Please get in touch if you have any queries going forward. Thank you.
Kind Regards