A Realist Evaluation of Case Management Models for People with Complex Health Conditions Using Novel Methods and Tools—What Works, for Whom, and under What Circumstances?

Round 1

Reviewer 1 Report (Previous Reviewer 2)

- The ethical processing and study period/timeline is now clear. 

- The conclusion should be shortened and simply highlight the main conclusions and related practical impact. I would also suggest to change an expression such as "The authors are not aware of any similar study which examines different...". Indeed, the authors are supposed to have done a careful and extensive literature research to complete the discussion of the present paper.

- A structured abstract could be advisable.

 

Author Response

 

Reviewer comments and authors responses                       22 February 2023

 

Dear editor,

 

We acknowledge and appreciate the time commitment, comments and specific feedback provided by the reviewer. Below is the reviewer comments (in blue) and the authors responses.  

 

Reviewer 1

The ethical processing and study period/timeline is now clear. 

- The conclusion should be shortened and simply highlight the main conclusions and related practical impact. I would also suggest to change an expression such as "The authors are not aware of any similar study which examines different...". Indeed, the authors are supposed to have done a careful and extensive literature research to complete the discussion of the present paper.

The first sentence was revised to reflect the literature search prior to and after the study. The conclusion was revised (second sentence) and a sentence removed to reduce the conclusion as advised by the reviewer.

- A structured abstract could be advisable.

The journal guidelines on the template specifically advise “ We strongly encourage authors to use the following style of structured abstracts, but without headings”. This contradicts the reviewers advise. Bearing this in mind, we have revised the abstract. We did not consider it necessary to change the order information as it already followed the usual structure of presentation (background, methods, results and conclusions).

However, in an attempt to meet the reviewers requirements we included words such as purpose (instead of objective) used ‘methods’ twice and results more frequently.

We trust that this meets both the journal’s requirements and the reviewers advise.

We have provided the revisions in the document uploaded with track changes evident.

 

Thank you and kind regards,

 

Sue Lukersmith on behalf of the authors.

 

This manuscript is a resubmission of an earlier submission. The following is a list of the peer review reports and author responses from that submission.

Round 1

Reviewer 1 Report

I find the idea of the work interesting even if it is explained in a very complex and unclear way to the reader. I believe that authors should strive to make the text more understandable, especially to readers who do not belong to the authors field. I believe that at the moment the article, as it was presented, is a bit far from the audience of this journal. Furthermore, the length of the text is too much, as is the number of sub-paragraphs . Furthermore, the presentation of the discussion is unclear. I recommend reviewing the entire structure of the introduction and discussion, clearly presenting the objectives of the study.

Reviewer 2 Report

The IRB approval is not completely clear. The authors state “Ethics approval was also sought and approved in 2019 at 197 the first and second authors former employer’s Human Ethics Research Committee (Australian National University 198 (#2019/15).” It is not clear where (institution) the study participants were recruited, and it is not clear why the IRB approval is in the middle of the study period (late 2018-2020).

- By the way, the study period should be exactly defined and not so approximatively.

- Figure 1 has some graphical flaws (e.g. see arrows)

- Figure 2: the caption should be much more explicative. In the current version, it is very poor.

- In general, all the figures need more detailed captions.

- The authors seems to disclose that these results has been already and/or partially used or analyzed in one of their previous papers. Indeed, they report ref. 36 in the results section. This point should be clarified better.

- In the results, the descriptive analysis should not include only gender and age. A detailed, even if aggregated, descriptions of injuries and disabilities should be given.

- I am not sure all the conclusions can be supported by the current analysis, due to the several and major limitations of this study.

Reviewer 3 Report

 

Abstract:

Define what is Case management

The sentence of objective of the study is extremely long, and unclear. What is “better” understand?

“throughout a ten-year period post injury recovery pathway of people who sustained a brain injury or 15

spinal cord injury” is the method not objective.

 

Introduction

Define and give a concise introduction on Case management. It is not clear.

Rewrite the objective, remove the aim.

Methods

Change table to a flow chart

Try not to use abbreviations

Figure 1 is not satisfactory. Please redo it.

Enlarge Figure 2, a HD image is essential.

Results

Standardize Figure 4 and 5

Do not split Table 3 into 2 pages, redo the Table.

Do not use point for for section 3.2

Discussion

Discuss the mixed methods secondary analysis

Do not use point for for limitations of the study.

Conclusion

Rewrite the conclusion, which should address the study objective