Enhancing Sustainability in Health Tourism through an Ontology-Based Booking Application for Personalized Packages

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This paper focuses on targeting HT managers, assisting them in comprehending the potential of their natural resources (e.g., hot springs or hiking trails) through an ontology concept. Also, this research presented a gap in ontologies relating to tourism, medical appointments, and HT as a whole. Even though this paper is interesting research, some further considerations are the following:

1. The paper adequately explains and contextualizes the theoretical background with relevant empirical research. However, the contribution or differences of the current research need to be more explicitly highlighted in this study. In other words, the theoretical background is necessary to be presented in detail as empirical research.

2. The research design is described in detail, but the research questions and hypotheses are not explicitly stated. Providing clear research questions and hypotheses would strengthen the study’s framework. Also, the methodology is presented in detail such as questions, research design, etc.

3. The part of the conclusion needs to enhance the paper’s contribution. Also, it needs to address the limitations of the study and suggest directions for future research for a more comprehensive conclusion.

4. Please check the reference format of this journal. It needs to modify that referencing is appropriate and sufficient for the study’s scope.

In conclusion, the paper presents a novel approach and has potential, but significant improvements are needed in the formulation of research questions and hypotheses, deeper analysis in the discussion section, and more explicit connections to existing research.

Comments for author File: Comments.pdf

Author Response

Thank you for the opportunity to revise our manuscript with ID: sustainability-3081320 entitled “Enhancing Sustainability in Health Tourism through an Ontology-Based Booking Application for Personalized Packages”. 

We greatly appreciate all the constructive comments provided by the Reviewer. All have been taken into account in order to strengthen our work. Please find the detailed responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files.

We hope that the Reviewer will find our responses and resulting improvements satisfying and we would like to express our willingness to incorporate any further suggestions that may derive from this revision.

Comment 1: The paper adequately explains and contextualizes the theoretical background with relevant empirical research. However, the contribution or differences of the current research need to be more explicitly highlighted in this study. In other words, the theoretical background is necessary to be presented in detail as empirical research.

Answer 1: We thank the Reviewer for the insightful feedback. We appreciate them for highlighting the importance of explicitly outlining the study's contribution. We acknowledge the identified gap and to address this, we've incorporated a new addition to the Related Work section. This new addition emphasizes the unique value proposition of our research. Available studies have explored aspects of HT, but there's a need for dedicated booking applications that offer personalized HT packages. Our proposed ontology-driven approach for HTH, the application we're presenting, directly addresses this gap. We are thankful for the reviewer’s input, which has enriched the quality of our research. The theoretical background is now presented in detail, aligning with the requirements of empirical research.

{Changes: Related work, Lines: 125-140}

 

Comment 2: The research design is described in detail, but the research questions and hypotheses are not explicitly stated. Providing clear research questions and hypotheses would strengthen the study’s framework. Also, the methodology is presented in detail such as questions, research design, etc.

Answer 2: We recognize the importance of clearly outlining the research questions and hypotheses for a robust study framework. We have added a dedicated section (1.1) that explicitly details the research questions and hypotheses. These elements guide the research design and data collection methods employed in the study. The manuscript is much stronger with this improved structure, and we're confident it will lead to a more focused and impactful study. We truly appreciate your feedback in helping us refine this research.

{Changes: Introduction (1.1), Lines: 92-123}

 

Comment 3: The part of the conclusion needs to enhance the paper’s contribution. Also, it needs to address the limitations of the study and suggest directions for future research for a more comprehensive conclusion.

            Answer 3: We have carefully considered your input and have made revisions based on your recommendations. In detail, we've incorporated a clearer statement about the paper's contribution to the field and we've explicitly acknowledged the limitations of the study. The conclusion clarifies how these limitations might affect the generalizability of the findings. Additionally, expanding on the future research directions has enriched the conclusion by suggesting actionable pathways for further exploration and development in the field. We believe these revisions strengthen the conclusion section and we thank the reviewer for the suggestions.

{Changes: Conclusion, limitations, and future recommendations, Lines: 901,946-969}

Comment 4: Please check the reference format of this journal. It needs to modify that referencing is appropriate and sufficient for the study’s scope.

Answer 4: All citations were individually checked and cited in the manuscript using Mendeley Reference Manager and Mendeley Cite add-in for Microsoft Word. DOI identifiers were included, citation format was fixed and wrong citations were corrected. Specifically, we have reviewed and formatted website references to ensure consistency with the overall reference style.

 https://www.mendeley.com/reference-management/reference-manager 

 https://www.mendeley.com/reference-management/mendeley-cite

{Changes: References (36, 39, 40, 41, 46, 48), Lines: 1075, 1082, 1084, 1086, 1093, 1096}

 

Additional comment: In conclusion, the paper presents a novel approach and has potential, but significant improvements are needed in the formulation of research questions and hypotheses, deeper analysis in the discussion section, and more explicit connections to existing research.

Answer: We appreciate the feedback and have undertaken revisions to address these points. We strengthened the contribution by highlighting the research gap, research questions and hypotheses were added for a clearer framework, the conclusion now emphasizes the paper's contribution, acknowledges limitations, and proposes future directions. Finally, all citations were checked and formatted according to the journal's guidelines. These enhancements aim to ensure our paper is both impactful and aligned with the rigorous standards of the field. We believe the reviewer's insights have been instrumental in improving the quality and clarity of our research.

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The online platform health-tourism1 provides information on HT services, allowing users to access details about medical specialties, treatments and destinations while facilitating communication with medical centers [11]. Another similar HT website is Medical Tourism2, a cost-free and informational platform designed for people seeking information on HT locales, prices and services, healthcare providers and clinics [12]. The application Health & Medical Tourism in Italy3 includes HT packages tailored for patients looking to combine rehabilitation with a vacation in Italy [13]. The HT packages provided by the 106 online medical travel marketplace PlacidWay4 , do not encompass accommodation and 107 tourist activities [14]. Lastly, Iran Health Tourism Organizer5 (IRHTO) is a platform where users can apply to book a package, including medical appointment, accommodation and 109 transport [15]. - Please indicate how authors made this list.

 

The research unveils user perceptions and experiences regarding HT and the HTH platform. - Since this research is highly associated with practical application, I recommend you to write more practical usage from research outcomes.

Comments on the Quality of English Language

N/A

Author Response

Thank you for the opportunity to revise our manuscript with ID: sustainability-3081320 entitled “Enhancing Sustainability in Health Tourism through an Ontology-Based Booking Application for Personalized Packages”. 

We greatly appreciate all the constructive comments provided by the Reviewer. All have been taken into account in order to strengthen our work. Please find the detailed responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files.

We hope that the Reviewer will find our responses and resulting improvements satisfying and we would like to express our willingness to incorporate any further suggestions that may derive from this revision.

Comment 1: The online platform health-tourism1 provides information on HT services, allowing users to access details about medical specialties, treatments and destinations while facilitating communication with medical centers [11]. Another similar HT website is Medical Tourism2, a cost-free and informational platform designed for people seeking information on HT locales, prices and services, healthcare providers and clinics [12]. The application Health & Medical Tourism in Italy3 includes HT packages tailored for patients looking to combine rehabilitation with a vacation in Italy [13]. The HT packages provided by the 106 online medical travel marketplace PlacidWay4, do not encompass accommodation and 107 tourist activities [14]. Lastly, Iran Health Tourism Organizer5 (IRHTO) is a platform where users can apply to book a package, including medical appointment, accommodation and 109 transport [15]. - Please indicate how authors made this list.

Answer 1: Thank you to the reviewer for their thoughtful comments on our paper. We appreciate their suggestion to further clarify the methodology used to identify existing HT platforms. We acknowledge the identified gap and to address this, we have added a sentence to the manuscript that clarifies this point: “The following list of existing HT platforms was compiled through a combination of methods, including relevant research and web search using keywords related to HT like “health tourism platforms”, “health tourism booking“, “global healthcare travel“, “medical tourism websites“, and “wellness travel“.  “

{Changes: Related work, Lines: 149-152}

Comment 2:  The research unveils user perceptions and experiences regarding HT and the HTH platform. - Since this research is highly associated with practical application, I recommend you to write more practical usage from research outcomes.

Answer 2: We appreciate your suggestion and have enriched the document accordingly. In the revised version, we detail how the survey results can be directly applied to enhance the HTH application's functionality and user experience. We believe these revisions demonstrate the practical applications of our research and their potential to improve the HTH platform significantly. Your feedback has been instrumental in strengthening this document, and we are grateful for your guidance.

{Changes: Conclusions, limitations, and future recommendations, Lines: 927-929, 933-934, 939-945}

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

The subject of the research and its purpose are relevant, of great interest and topical.  They constitute significant contributions to knowledge and research development with important social and management impacts on health tourism.

It has an appropriate structure, with logical organisation of the contents and up-to-date documentation.

It should be noted that the introduction is well-developed and adequately substantiated, in line with the theme and title of the research, but the goals should be more clarified and systematised, as well as indicating the organisational structure of the article.

In the related Work, it would be important to develop infograms or a table that would allow the information to be systematised, making it easier to analyse and interpret.

In the evaluation (User Survey) there should be greater detail or clarification of the process followed, in terms of development and application, as well as ensuring that data protection issues are taken into account.

The results should include a summary table or systematisation of the main results achieved, pointing out logics for the future and ways of applying them.

Comments on the Quality of English Language

Minor editing of English language required

Author Response

Thank you for the opportunity to revise our manuscript with ID: sustainability-3081320 entitled “Enhancing Sustainability in Health Tourism through an Ontology-Based Booking Application for Personalized Packages”. 

We greatly appreciate all the constructive comments provided by the Reviewer. All have been taken into account in order to strengthen our work. Please find the detailed responses below and the corresponding revisions/corrections highlighted/in track changes in the re-submitted files.

We hope that the Reviewer will find our responses and resulting improvements satisfying and we would like to express our willingness to incorporate any further suggestions that may derive from this revision.

Comment 1: The subject of the research and its purpose are relevant, of great interest and topical.  They constitute significant contributions to knowledge and research development with important social and management impacts on health tourism.

It has an appropriate structure, with logical organisation of the contents and up-to-date documentation.

It should be noted that the introduction is well-developed and adequately substantiated, in line with the theme and title of the research, but the goals should be more clarified and systematised, as well as indicating the organisational structure of the article.

Answer 1: Thank you to the reviewer for their thoughtful comments on our paper. We appreciate them taking the time to provide such valuable insights. We'd like to acknowledge their suggestion regarding clarifying our research goals and outlining the organizational structure of the article. We've incorporated these changes into the revised manuscript. We've strengthened the introduction by explicitly stating our research goals, which include evaluating the effectiveness of HealthTourismHub (HTH) in improving user experience and streamlining the booking process. We've also improved the flow of the paper by mentioning the upcoming sections in the introduction. This provides a roadmap for the reader and clarifies how the research unfolds. We believe these revisions address the suggestions and enhance the overall clarity and organization of our paper.

{Changes: Introduction (1.1), Lines: 92-122}

Comment 2: In the related Work, it would be important to develop infograms or a table that would allow the information to be systematised, making it easier to analyse and interpret.

Answer 2: We have now incorporated a table (Table 1) that systematically compares existing HT platforms. The table provides a clear overview of these platforms, highlighting their functionalities and limitations. We believe this table will allow readers to easily analyze and interpret the functionalities offered by different platforms, further emphasizing the unique value proposition of our proposed application. We are confident that this revision strengthens the overall quality of the manuscript.

{Changes: Related work, Table 1, Lines: 181-185}

Comment 3:  In the evaluation (User Survey) there should be greater detail or clarification of the process followed, in terms of development and application, as well as ensuring that data protection issues are taken into account.

Answer 3: In response to the suggestions, we have incorporated the following enhancements within the User Survey section:

• To evaluate user experience, participants interacted with the HTH platform individually using role-specific guides. 
• A diverse online sample ensured a broad range of perspectives.
• Transparency was key, with participants informed about the study and their rights. Secure data storage and access restrictions protected confidentiality. 
• The survey itself, informed by literature and web searches, used clear and unbiased questions to assess user experience with HTH.

The revised evaluation section now provides a detailed and transparent account of the survey development and application processes, addressing the reviewer’s concerns regarding clarity and data protection. We strongly believe these improvements enhance the robustness and transparency of our research

{Changes: Evaluation (4.1), Lines: 589-600}

Comment 4: The results should include a summary table or systematisation of the main results achieved, pointing out logics for the future and ways of applying them.

Answer 4: We inform the reviewer that the suggestion has been carefully considered, and our manuscript has been adjusted based on the feedback provided. For a more structured and impactful way to present the main results, we implemented a table (Table 4) within the Evaluation section which provides a clear and concise overview of the key findings, improving the readability and accessibility of the information.

We have also incorporated the reviewer's suggestion to include a summary of the key findings within the Discussion section, pointing out some logics for the future.  Additionally, we made improvements to the Conclusions, Limitations, and Future Recommendations section (Lines: 933-934, 938-945) to highlight key areas for improvement within the HTH platform.

 In response to the reviewer's suggestion for further exploration, we've added a paragraph that proposes areas for future research (Lines: 959-969). This addition outlines several key areas for further investigation that build upon the findings of our current study. We believe that by pursuing these diverse future research directions, we can gain a more comprehensive understanding of the HT landscape, the needs and preferences of various stakeholders, and ultimately contribute to the responsible growth of the HT industry.

{Changes: Evaluation(4.1, Table 4), Lines: 826-830, Discussion, Lines:882,900  and Conclusion, limitations and future recommendations, Lines: 933-934, 938-945 and 959-969}

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The researchers have revised and improved the paper as requested, significantly enhancing its quality. However, the conclusion section is currently labeled as '6. Conclusions, limitations, and future recommendations. Typically, these sections are separated individually or divided into 'Conclusion' and 'Limitations and Future Research'. Therefore, please split the conclusion section and present the content more specifically and clearly. Once this revision is complete, the paper will be suitable for publication in this journal. Thank you for your hard work.

Author Response

Thank you once again for the opportunity to revise our manuscript with ID: sustainability-3081320 entitled “Enhancing Sustainability in Health Tourism through an Ontology-Based Booking Application for Personalized Packages”. 

Comment 1: The researchers have revised and improved the paper as requested, significantly enhancing its quality. However, the conclusion section is currently labeled as '6. Conclusions, limitations, and future recommendations. Typically, these sections are separated individually or divided into 'Conclusion' and 'Limitations and Future Research'. Therefore, please split the conclusion section and present the content more specifically and clearly. Once this revision is complete, the paper will be suitable for publication in this journal. Thank you for your hard work.

Answer 1: We would like to inform you that we have taken your suggestion into consideration and have separated the Conclusions section into three distinct parts: General conclusions, Limitations, and Recommendations for future research. This restructuring provides a clearer and more focused presentation of the study’s findings, shortcomings, and potential avenues for future research. We believe that these revisions have substantially improved the paper and we are confident that the paper is now suitable for publication. We appreciate your guidance throughout this process.

{Changes: Conclusions, Lines: 901,902,948,963}

Author Response File: Author Response.pdf