Value Propositions of Public Adult Hearing Rehabilitation in Denmark

Round 1

Reviewer 1 Report

Dear The Authors,

I very much enjoyed reading your manuscript. Your study provides valuable insights into what is valued by hearing aid recipients and these findings will be useful to optimise service delivery and further develop patient-centered audiological care.

The manuscript was well-written and the methodology was sound, so I therefore only have minor comments.

 

Line 1 - 'obtaining' should be changed to 'obtain'

Since your study sample consisted of older adults only, as a limitation, please include that the findings may only be applicable to older adults and not generalisable to the younger population. 

 

Author Response

Thank you for the review.

Point 1: Line 1 - 'obtaining' should be changed to 'obtain'

Done. 'obtaining' has been changed to 'obtain'.

Point 2: Since your study sample consisted of older adults only, as a limitation, please include that the findings may only be applicable to older adults and not generalisable to the younger population. 

We agree, the results presented in the manuscript are representative of the population that participated in the studies. A conclusion was added,  Section 7 in the revised manuscript, in which this point is emphasized.

   

Reviewer 2 Report

The authors wrote an article regarding the Value propositions of public adult hearing rehabilitation in Denmark. The manuscript is not so interesting, but it is well written and the topic is important.

I'm a ENT, so I can judge the quality of content that is good. The manuscript should be evaluated by a statistician expert.

Please, translate or remove figure 1

Author Response

Thank you for the review.

Point 1: I'm a ENT, so I can judge the quality of content that is good. The manuscript should be evaluated by a statistician expert.

The statistical methods applied in the study are well documented (see references 14-19) and have been used to evaluate preference judgements from paired comparisons is several different domains (see references 20 and 22). The methods are applied here using the same procedure described in [20]. This procedure has been implemented in a MATLAB and and R functions accessible through the wed. See reference 20 for details.

Point 2: Please, translate or remove figure 1

Figure 1 with the screen shot of the web application with the original danish text has been removed.

 

Reviewer 3 Report

The researchers suffer redundancy in all its aspects particularly in the materials and methods section.

the original sample size was small, only 12 cases that were limited in age and were heterogenous.

Is a methodology section, it is not clear that interviewing the 12 cases which was followed by further evaluation through 173 experienced hearing aid users clinicians and healthcare experts

In Table 1, the list of value prepositions from 1 to 8 in the title while in the table itself the numbers appear between 02 and 09. Is this intentionally made by the authors or there is a defect in numbering the values? The same discrepancy was found in Table 2 and 3. Not all values were present why?

 

The work is good however it needs more refinement in its scientific writing and the correction for many spelling mistakes and mini statement are difficult to understand

Author Response

Thank you for the review.

Point 1: The researchers suffer redundancy in all its aspects particularly in the materials and methods section.

The reviewer makes a good point and we are thankful for the opportunity to improve the manuscript. The entire manuscript has been revised with focus on removing redundancies and improving the readability. As the study comprises two separate parts, harvesting value propositions and evaluation through paired comparisons, the revised version now includes two "Materials and methods" sections and two "Results" sections, one for each part of the study. This also addresses the confusions regarding the number and characteristics of participants in each part of the study. 

Point 2: the original sample size was small, only 12 cases that were limited in age and were heterogenous.

Is a methodology section, it is not clear that interviewing the 12 cases which was followed by further evaluation through 173 experienced hearing aid users clinicians and healthcare experts

The study sample of the first part of the study consists of 12 hearing aid users and 11 hearing care professionals. The interviews were carried out until saturation occurred and very few new insights were obtained. The sample of hearing aid users that participated in the interviews (harvesting value propositions) contains both new and experienced users and it is representative of the age group that is typically referred to the clinics in the Danish health care system.  We agree that a similar study with different populations and contexts will likely lead to difference value propositions and to different subsequent preferences, as it should. Taking other factors into account, such as, accessibility, device connectivity or price could help the development of priorities of service from concrete user experiences.

This point is addressed both in the new material and method sections were a clear distinction is made between which participants were involved in each part of the study. Additionally, the conclusion added to the manuscript also outlines the limitations of the study.

Point 3: In Table 1, the list of value prepositions from 1 to 8 in the title while in the table itself the numbers appear between 02 and 09. Is this intentionally made by the authors or there is a defect in numbering the values? The same discrepancy was found in Table 2 and 3. Not all values were present why?

In the original manuscript, Tables 1-3 only contained the value propositions that were used for the preference judgements, so they did not contain the value propositions eliminated following the criteria explained in Section 3.2. This was corrected so the new Tables 1-4 now show all 29 value propositions obtained from the distillation process, described in Section 2 and presented in Section 3. The chosen value propositions are now highlighted with bold font headlines and numbers in the new Tables 1-4.  In figures 2-4 the y-axis contains the 21 chosen value propositions with the corresponding numbers from the original list of 29, thus they are not numbered sequentially. In the text the value propositions are referred to by number and headline in quotation marks or simply by the number from Tables 1-4.

Point 4: The work is good however it needs more refinement in its scientific writing and the correction for many spelling mistakes and mini statement are difficult to understand

The manuscript has been completely reviewed and revised to avoid spelling errors and to improve the scientific communication. We are confident of having addressed all of the reviewers comments. Specifically, the manuscript has been restructured so that each part of the study has its own method and materials (Sections 2 and 4), as well as, results sections (Sections 3 and 5). Additionally a new Conclusion section has been added (Section 7) to address some of points mentioned in the review. 

 

 

 

 

 

Round 2

Reviewer 3 Report

Nice effort. Thanks