Crossing the AI Chasm in Neurocritical Care

Round 1

Reviewer 1 Report

The article is very well organised, concise enough and from where I am standing, clearly meets its goals. Congratulations on that.

I will only a few recommendations and all of them are minor English sentence making/vocabulary suggestions. 

If I had to guess, the introduction was written by one (or a group of) author(s) different from the the rest of the article: the south mediterranean influence is quite clearly identified in the introduction whereas it is not so in the other paragraphs. 

Therefore, I would suggest reviewing the introduction as a whole, not for its content but for the sentence-making.

Here follow some light suggestions (in bold): 

Lines 52/53: "has become an invaluable tool to improve patient care and facilitating clinical decision-making while reducing resources consumption"

Line 61: "traumatic brain injury patients"

Line 62: "(...) with the same aim"

Line 64: "strategies have also been adopted"

Line 66: use speech connector "(...) prediction of both neurological recovery (...) and delayed cerebral ischaemia"

Line 84: "as overcoming this gap"

Line 177: "may attempt not only to exploit (...) but also to gain (...)" - because the first issue mentioned was already referred to 2 lines above

Author Response

We express our sincere gratitude to the reviewer for the valuable suggestions, which helped us to enhance the quality of the manuscript. 
In response to the reviewer's comments, we have conducted a thorough revision of the article to ensure that all sentences are well-structured and convey the intended meaning. We have also taken into account the reviewer's suggestions to improve the clarity and coherence of the text. 
Furthermore, we have added a new figure to the article (Figure 1). We hope that by providing a visual representation of the concepts, the figure could help to make the article more accessible to a wider audience and increases its potential impact.
Additionally, we have included several new bibliographic references to strengthen the literature review and provide further evidence to support our arguments.

Reviewer 2 Report

I am really happy with this work because we need this type of research to raise awareness about the factors influencing the lack of use of AI approaches for the medical field in general and the neurocritical care in particular. The content is well thought, nicely written and the authors explain thoroughly the main concerns from ethical, regulatory, trust, and acceptance perspectives. My recommendation is to publish this article. My only very minor suggestion is to think about the sections organization if there is a better way to organize the content.

Author Response

Thank you for your words of appreciation. We have completely revised the text.

Reviewer 3 Report

The work is a state-of-the-art review of the actual application of AI in healthcare.

The article is well-written and its presentation is clear. The references are adequate and the analysis details the constraints of this type of application. Some solutions are proposed to close the gap. However, with regard to ethical issues, I do not currently see government movements in this direction, particularly in democratic societies where using a medical examination for science is a problem, but collecting all and any information from a personal cell phone is systematic. In fact, alerting to this disparity in the way data are treated would probably require another article.

That's why I hope that in the future articles like this one can have some impact at higher levels.

Author Response

We express our gratitude to the reviewer for providing the valuable suggestion. It was noted that the previous version of the manuscript lacked an important aspect pertaining to ethics. To address it, we have made the necessary additions to the new version of the manuscript. We believe that this improvement will enhance the quality and significance of the submission.

Reviewer 4 Report

In this manuscript, Cascella et. al. have compiled an interesting review of AI and its emerging role in neurocritical care. This review is interesting and timely as AI has significantly expanded to different levels of the healthcare sector. But the authors need to carry out a more exhaustive review.

- The authors need to significantly expand the scientific component of the manuscript.

-  The authors can add more recent / relevant literature to strengthen the manuscript.

- The authors need to add more tissue levels and molecular components to enhance heterogeneity at tissue and clinical levels.

- The authors need to add references in Table 2.

- The authors can significantly enhance the manuscript through the addition of a couple of figures.

- The authors need to improve the overall flow of the manuscript and refrain from informal sentences such as:

"Thanks to the incredible potential of data collection, neuro-ICU is the most suitable 357 setting for AI-based research and applications."

Author Response

We express our appreciation for the valuable suggestions provided. As a response, we have conducted a thorough revision of the text, with a particular focus on its scientific content. To strengthen the concepts presented, we have included several relevant bibliographic sources in the revised version of the paper. These sources serve to reinforce the arguments and also provide additional reading recommendations for interested readers.

Furthermore, we have added a new figure to the article (Figure 1). We hope that by providing a visual representation of the concepts, the figure could help to make the article more accessible to a wider audience and increases its potential impact.

We added references in Table 2.

Finally, we appreciate your feedback and took your suggestions into consideration. We understood the importance of maintaining a consistent flow and tone throughout the manuscript and worked to improve the overall structure and formality of the sentences. As a result, we conducted a thorough review of the manuscript to ensure that it adhered to the standards of academic writing. Once again, thank you for bringing this to our attention.

Round 2

Reviewer 4 Report

The authors have done an excellent job revising the manuscript.