Mapping of the Interests and Influences Perceived in the Actors That Make Up the National System of Innovation in Rehabilitation in Colombia

Round 1

Reviewer 1 Report

This article is well presented, but I advise the authors to improve the presentation of the results. 

Author Response

This article is well presented, but I advise the authors to improve the presentation of the results.

 

Dear Reviewer 1, we appreciate your feedback on our article. According to your suggestions, we have checked the presentation of the results and we found some translation errors in Figure 1, which have already been corrected in this latest version of the manuscript.

We have decided to keep the heat maps of the interest and influence of the actors to make the data visual and readable.

We would like to thank you for your comments on the manuscript and we hope that this final version with improvements will be approved for publication.

Reviewer 2 Report

First of all, congratulations to the authors of this article.

Very important and relevant topic for the scientific community

Line 49-51 – reference used?

Lines 149-161 – references used?

Materials and Methods – clarify when the study took place (time horizon); what is the statistical program used in the analysis and treatment of the data?

Advantages and implications of this study are identified. And what are the limitations of this study?

Author Response

Dear Reviewer, we appreciate your feedback on our article.

Line 49-51 – reference used? Lines 149-161 – references used?

R:/ Dear Reviewer 2, thank you for your comments and the review of our manuscript. Based on these observations, the references used in lines 49-51 and 149-161 from the original submission were revised and then incorporated into the manuscript.

Materials and Methods – clarify when the study took place (time horizon); what is the statistical program used in the analysis and treatment of the data?

R:/ For the Materials and Methods section, the time horizon for the current study was clarified. This research was carried out in Colombia as a case study, including its 32 departments and its capital Bogotá. Additionally, it was clarified in the manuscript that the fieldwork lasted seven months, ending in March 2022, and was carried out through virtual and face-to-face meetings with the different actors in the system.

Advantages and implications of this study are identified. And what are the limitations of this study?

R:/ At the end of the discussion section, an extension was included that mentions the advantages and limitations of this study, accepting the suggestions received during the review. Please see page 13 containing the advantages and implications of this study.

We want to thank you for your comments on the manuscript and we hope that this final version with improvements will be approved for publication.

Reviewer 3 Report

1. Context and link to sustainability need to be made clearer. How does the topic relate to sustainability? What SDGs does this research help develop/support? Clarifying this will help clarify the research questions...

 

2. Literature needs to be improved, number of references is very limited, Furthermore, major issue on innovation for rehabilitation is missing. Review should consider p.e. quality, risk and compliance issues on Innovation for rehabilitation (especially technical and technological).

 

3. The limited review identified in the previous point results in missing/lacking of identification of key steps is the process. Any technological innovation to be used in the context of health (even if non invasive) will require a deep analysis of risk and compliance? An example of what i am talking, for medical devices:

https://www.emergobyul.com/services/colombia/colombia-medical-device-registration

 

4. In the same sense, a whole group of interested parts is missing in relation to quality, risk and compliance management. These actors will have varying levels of influence in the process. I feel that the inclusion of a new group, called technology validation/verification would be essential

Author Response

Dear Reviewer 1, we appreciate your feedback on our article. According to your suggestions, we have checked the manuscript and here you will find responses to each one.

Context and link to sustainability need to be made clearer. How does the topic relate to sustainability? What SDGs does this research help develop/support? Clarifying this will help clarify the research questions...

R:/ Dear reviewer, we appreciate the recommendations received during the evaluation process and feedback on the manuscript.

To make the relationship between this article and the contribution generated by the results of the work to the SDGs clearer and more coherent, we include a description in the document (Line xxx).

This work is articulated with the development objective "Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation" whose purpose is, among others, to support the development of technologies, research, and national innovation in developing countries.

 

Literature needs to be improved, number of references is very limited, Furthermore, major issue on innovation for rehabilitation is missing. Review should consider p.e. quality, risk and compliance issues on Innovation for rehabilitation (especially technical and technological).

R:/ More references associated with the topic were added to this article, accepting the recommendations received. However, the searches carried out show that the volume of publications on problems of quality, risk, and compliance of innovation for rehabilitation is limited.

The limited review identified in the previous point results in missing/lacking of identification of key steps is the process. Any technological innovation to be used in the context of health (even if non invasive) will require a deep analysis of risk and compliance? An example of what i am talking, for medical devices: https://www.emergobyul.com/services/colombia/colombia-medical-device-registration In the same sense, a whole group of interested parts is missing in relation to quality, risk and compliance management. These actors will have varying levels of influence in the process. I feel that the inclusion of a new group, called technology validation/verification would be essential

 R:/ The steps for technology transfer were clarified in the manuscript. In this context, technology evaluation studies to optimize their quality and usability are an essential component to guarantee the quality of the devices developed and minimize risks during the process of transferring technology from the laboratory to the clinic, even more so when there is a need regarding the collection of patient-centered data that help guide the care process.

It is considered that technology validation/verification are not actors per se but driving or limiting forces of the market.

Reviewer 4 Report

Comments for author File: Comments.pdf

Author Response

Dear reviewer 4, thank you very much for reviewing the manuscript and for making suggestions for the improvement of our article.

 Abstract

The abstract seems logical in sequence but to specify the study context please also mention the province or city from where the data was collected. Adding implications will also enhance the readability of the manuscript.

R:/ The article specified the province or city from where the data was collected. Additionally, a mention was made of the implications of this research in the abstract and discussion.

Introduction

Authors have written 5 – 6 line paragraphs with a single sentence like the first paragraph or provided facts without any reference (see lines 44 and 45). This should be avoided. All the sentences must be linked with each and similarly, all the paragraphs should also be interlinked.

R:/ Based on these observations, the references used in lines 49-51 and 149-161 from the original submission were revised, and then incorporated into the manuscript. The wording of the ideas was also revised.

In general, the introduction is written to attract the intentions of readers by highlighting the background, research gap, and at the end presenting how this research will fill the existing gap? However, this research hasn’t provided any such detail, therefore it is recommended to rewrite this section so that the readability of the paper can be enhanced. The gap should be justified by considering why and how to study the effectiveness of innovation activities in rehabilitation in Colombia. Furthermore, the authors of this study need to give the rationale behind conducting this research. In other words, proper case building is required with aims and objectives.

R:/ In accordance with the observations proposed in this comment, a new Introduction section was prepared to enhance the readability of the paper and incorporate all the aspects that were recommended for its preparation.

Literature Review

First of all, provide the operational definitions of all the variables. Secondly, the literature review is not thematically connected. Defining the objective of the study or research question can guide towards the direction of the literature review, so needs proper connectivity to the problem of the study. Furthermore, authors need to link the study with any existing theory like diffusion of innovation theory or any other so that study can have a sound theoretical foundation.

R: / The literature review was complemented by the comments received. The ideas in this section have been organized to seek a thematic connection and connect it to the research problem.

Methods

What does the “Likert scale type” scale? Use proper terminologies. As per my knowledge, there

is no such scale.

R:/ The Likert scale is a rating scale applied in social sciences, quantitative market research, and even multivariate analysis. In its normal form, it attempts to record a respondent’s level of agreement with statements, and it could be used to assess a variable according to various studies available in the literature.  Although the term "Likert-type" scale is used in the literature, we decided to adjust its wording to just "Likert Scale" to make it more understandable in the manuscript.

In table 1, some dimensions are stated by the authors. There was no discussion in previous sections on these dimensions, no source is given with the table, from where they are adapted/adopted, or are they being assumed by the authors? There is no linkage between different sections, each section looks like a stand-alone section. This is a very serious problem with this research. Instead of being focused, it is diverging the readers. How the authors have developed Table 2? Justify each step. What is done in the study is against the basic principles of scientific study.

 

R: The primary sources of information for the research were the actors that are currently typified and recognized by the Colombian system of science, technology, and innovation (Ministry of Sciences - Minciencias), to whom a survey was applied with open and closed questions. This study adopted these dimensions.

Discussion

The discussion section needs some revisions to discuss the results. This discussion section is connecting findings to the literature, and theory, however, there is a need to make connectivity with practice also. Language is not up to the standard which needs proofreading.

R:/ Based on feedback received from reviewers, the discussion section has been organized and its presentation improved to connect it with practice, as suggested.

References

It is necessary to include the latest references from 2021 and 2022 particular to this topic to know about what has been done on this topic recently and what needs to be done.

R:/ In this final version, references were included in the window between 2021-2022 related to the topic.

We want to thank you for your comments on the manuscript and we hope that this final version with improvements will be approved for publication.

Round 2

Reviewer 3 Report

Thank you for your review. Some minor aspects still need to be addressed, but relevant changes have been made.

1. In regards to the the alignment with the Sustainable Development Goals, they should be addressed as such, and clearly identified. In this sense, you should refer to them as United Nations's Sustainable Development Goal #9 - Industry, Innovation and Infrastructure and not as "development objective".

 

2. I don't agree with your stance that organizations responsible for verification, validation, and assessment of the safety, security and risk of medical devices are "driving forces" instead of actors. If you cannot integrate a new group of actors related with technology sefety and validation,  and to analyse their impact in deth, that should be considered as a limitations and clearly stated as such in the article.

Author Response

Dear reviewer 3,

Kind regards.

The authors appreciate your feedback and suggestions received for the article preparation.

Regarding the last two recommendations, we have made the applicable changes as follows:

1. The Sustainable Development Goals were addressed, and we referred to them as United Nations's Sustainable Development Goal #9 - Industry, Innovation and Infrastructure and not as "development objective."
2. We stated that organizations responsible for verification, validation, and assessment of the safety, security, and risk of medical devices are actors. As we cannot integrate this actor into the study, we declared this fact as a limitation to the study disclosed in the article.

Thank you.

Sincerely,

The Authors.

Reviewer 4 Report

the authors have improved the manuscript. it is clear from my side. 

Author Response

Dear reviewer 4,

The authors appreciate your feedback and suggestions in preparing the article. With this, we hope to be able to publish it successfully.

Best regards,

The Authors.