A Checklist to Assess Technologies for the Diagnosis and Rehabilitation of Geriatric Syndromes: A Delphi Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This is a quite interesting research article with adequate novelty. Some points should be addressed.

• I suggest to add more keywords after the Abstract.
• The 1st paragraph od the Introduction section should be enriched. The authors should add more details concerning the higher prevelance of specific diseases such as cardiovascular diseases, metabolic disorders and cancer in older adults.
• In the 2nd paragraph of the Introduction section, the authors should report more details concerning the quality of life of older adults such as the performance status of older adults patients.
• Relevant references should be added in the 4th paragraph of the Introduction section.
• More details concerning the Delfi method (line 102) should be added.
• The title of each table should be tranferred before each table.
• The tables are not readable and need to transfer the numbering right.
• The Table 3 seems to not be completed.
• The Discussion section included severar long and complex sentences that should be split into smaller sentences., e.g. 441-447, 448-453, 466-472.
• English language editing is highly recommended.
• There are several typos and grammar/syntax errors throughout the manuscript that should be revised.

Comments on the Quality of English Language

• English language editing is highly recommended.
• There are several typos and grammar/syntax errors throughout the manuscript that should be revised.

Author Response

Dear Editorial Board,

we, along with our co-authors, here provide a point-by-point response letter to the comments we received from Reviewer 1 to our manuscript titled “A Checklist to Assess Technologies for Diagnosis and Rehabilitation of Geriatric Syndromes: a Delphi study”. All the changes we performed to our manuscript and Supplementary Material file are highlighted in yellow.

LIST OF THE CHANGES, ANSWERING THE POINTS RAISED BY THE REVIEWER 1 (The Reviewer 1’ comments are in bold font, and our responses are in plain font)

REVIEWER # 1 COMMENTS

 

Comments to the Author

This is a quite interesting research article with adequate novelty. Some points should be addressed:

RESPONSE: We thank a lot the Reviewer for the feedback and remark.

 

1. Abstract:

I suggest to add more keywords after the Abstract.

RESPONSE 1: We thank the Reviewer for this helpful suggestion. As requested, we have added additional keywords after the Abstract to improve the discoverability of the manuscript.

 

2. Introduction:

The 1st paragraph of the Introduction section should be enriched. The authors should add more details concerning the higher prevalence of specific diseases such as cardiovascular diseases, metabolic disorders and cancer in older adults.

RESPONSE 2: We thank the Reviewer for this valuable suggestion. We have enriched the first paragraph of the Introduction by including additional information on the increased prevalence of cardiovascular diseases, metabolic disorders, and cancer in the older adult population, as recommended.

 

3. Introduction:

In the 2nd paragraph of the Introduction section, the authors should report more details concerning the quality of life of older adults such as the performance status of older adult patients.

RESPONSE 3: We appreciate the Reviewer’s insightful comment. In response, we have expanded the second paragraph of the Introduction to include additional details regarding the quality of life in older adults, with a specific focus on performance status indicators.

 

4. Introduction:

Relevant references should be added in the 4th paragraph of the Introduction section.

RESPONSE 4: We thank the Reviewer for the helpful suggestion. We have revised the fourth paragraph of the Introduction by adding relevant references to support and strengthen the statements presented.

 

5. Introduction:

More details concerning the Delphi method (line 102) should be added.

RESPONSE 5: We thank the Reviewer for pointing this out. We have added more details about the Delphi method at line 102 to better clarify its application and relevance within the context of our study.

 

6. Tables:

The title of each table should be transferred before each table.

RESPONSE 6: We thank the Reviewer for noticing this formatting inconsistency. We have now standardized the layout by placing the title above each table throughout the manuscript, in accordance with the journal’s guidelines.

 

7. Tables:

The tables are not readable and need to transfer the numbering right.

RESPONSE 7: We thank the Reviewer for this observation. We acknowledge that the tables in the PDF version may appear unreadable due to formatting issues caused by the journal’s file conversion system, which is unfortunately beyond our direct control.
We kindly invite the Reviewer to refer to the original .docx file, where the tables are correctly formatted and fully readable, including proper numbering and alignment.

 

8. Tables:

The Table 3 seems to not be completed.

RESPONSE 8: We thank the Reviewer for this observation. We confirm that Table 3 is complete. In the second part of the checklist, the "Specification" column is intentionally left blank for some items, as this follows the formatting and structure required by the journal’s guidelines. The current layout is therefore intentional and in line with the recommended submission format.

 

8. Discussion:

The Discussion section included several long and complex sentences that should be split into smaller sentences, e.g. 441–447, 448–453, 466–472.

RESPONSE 8: We thank the Reviewer for this helpful remark. We have revised the indicated portions of the Discussion section by simplifying and rephrasing several sentences, in order to improve clarity and reduce sentence length.

 

9. English language:

English language editing is highly recommended.

RESPONSE 9: We appreciate the Reviewer’s suggestion. We have carefully revised the manuscript to improve the clarity and fluency of the English.

 

10. Grammar/syntax errors:

There are several typos and grammar/syntax errors throughout the manuscript that should be revised.

RESPONSE 10: We thank the Reviewer for pointing this out. We have thoroughly reviewed the manuscript to correct all identified typos, grammar, and syntax errors to ensure the text is accurate and properly structured.

 

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This paper aims to develop and validate a checklist tool for assessing the diagnosis and rehabilitation technologies of geriatric syndromes, using the Delphi method and pilot testing. The study is well-designed and has clear objectives, but there are several areas that require further improvement and refinement.

Abstract (Page 1, Paragraphs 1–3):
The abstract highlights the importance of integrating technologies in elderly care but does not clearly specify the intended application scenarios or target user groups of the checklist tool. It is recommended that the abstract be supplemented with a description of the primary application contexts (e.g., clinical practice, research evaluation) and the anticipated users (e.g., clinicians, researchers, or policymakers), in order to enhance the completeness and practical value of the summary.

Introduction (Pages 1–3):
In lines 38–40 on page 1, this sentence "This process is influenced by a combination of genetic, environmental, and behavioral factors, which determine how each individual ages" would benefit from the addition of two relevant references to strengthen the evidence base [https://doi.org/10.1016/j.jesf.2025.03.004; https://www.nature.com/articles/s41598-024-56316-7]. In the fourth paragraph on page 1, the manuscript mentions a "lack of methodological rigor" but does not specify which methodological issues are most problematic in current studies (e.g., small sample sizes, lack of control groups). It is suggested to provide concrete examples or supporting data to reinforce this point.

In the first paragraph of page 3, it is stated that "translational research is hindered," but there is no detailed explanation of how the checklist tool addresses this issue. It is recommended to elaborate on the specific mechanisms or advantages by which the checklist promotes the translation of research findings into practice.

Methods (Pages 3–5):
In the second paragraph on page 3, the study mentions the use of a "four-round Delphi method," but does not provide details on the objectives of each round or how participant feedback was handled. It is advisable to elaborate on the tasks of each Delphi round (e.g., the first round identifies the structure, the second refines the items, etc.) and to explain how expert opinions were integrated.

On page 5, the first paragraph discusses "pilot testing" but does not describe the specific technologies used or the evaluation procedures. It would be helpful to add a case example from the pilot test to improve the transparency and reproducibility of the methodology.

Results (Pages 6–9):
Table 1 on page 6 presents the professional backgrounds and experiences of the participants but does not explain how these backgrounds influenced the checklist development. It is recommended to discuss how the experts’ backgrounds affected item selection (e.g., engineers focusing more on technical feasibility, physicians emphasizing clinical applicability).

Table 2 on page 9 lists the revisions and evaluations of the items but does not explain the specific reasons or criteria for modification. It is suggested to provide the rationale for item changes (e.g., vague language, content redundancy) to improve clarity.

Discussion (Pages 16–19):
In the second paragraph on page 16, the paper mentions the "practicality of the checklist" but does not discuss its potential limitations (e.g., applicability only to certain types of technologies or elderly populations). It is recommended to address the scope of the tool and possible directions for improvement.

In the third paragraph on page 18, the manuscript refers to "future research" but does not propose any concrete plans for follow-up studies. Suggestions should include clearly defined research directions (e.g., cross-cultural validation, long-term impact evaluation).

Formatting and Language Issues:
In the checklist tables on pages 10–15, some item descriptions (e.g., TRL1.1) are overly long and complex. It is recommended to simplify the language or list the content in bullet points to improve readability.

There are a few grammatical and spelling errors throughout the manuscript (e.g., in the second paragraph on page 2, “found” should be “find”). A thorough proofreading is advised to correct these minor issues.

Comments on the Quality of English Language

can be improved

Author Response

Dear Editorial Board,

we, along with our co-authors, here provide a point-by-point response letter to the comments we received from Reviewer 2 to our manuscript titled “A Checklist to Assess Technologies for Diagnosis and Rehabilitation of Geriatric Syndromes: a Delphi study”. All the changes we performed to our manuscript and Supplementary Material file are highlighted in yellow.

LIST OF THE CHANGES, ANSWERING THE POINTS RAISED BY THE REVIEWER 2 (The Reviewer 2’ comments are in bold font, and our responses are in plain font)

REVIEWER # 2 COMMENTS

 

Comments to the Author

This paper aims to develop and validate a checklist tool for assessing the diagnosis and rehabilitation technologies of geriatric syndromes, using the Delphi method and pilot testing. The study is well-designed and has clear objectives, but there are several areas that require further improvement and refinement:

RESPONSE: We thank a lot the Reviewer for the feedback and remark.

 

1. Abstract (Page 1, Paragraphs 1–3):

The abstract highlights the importance of integrating technologies in elderly care but does not clearly specify the intended application scenarios or target user groups of the checklist tool. It is recommended that the abstract be supplemented with a description of the primary application contexts (e.g., clinical practice, research evaluation) and the anticipated users (e.g., clinicians, researchers, or policymakers), in order to enhance the completeness and practical value of the summary.

RESPONSE 1: We thank the Reviewer for her/his useful suggestion. We inserted in the abstract a brief specification (page 1, lines 22-23; page 2 line 31) 

 

2. Introduction (Pages 1–3):

In lines 38–40 on page 1, this sentence "This process is influenced by a combination of genetic, environmental, and behavioral factors, which determine how each individual ages" would benefit from the addition of two relevant references to strengthen the evidence base [https://doi.org/10.1016/j.jesf.2025.03.004; https://www.nature.com/articles/s41598-024-56316-7].

RESPONSE 2.1: We thank the reviewer for this suggestion. We have added the references in the text

 

In the fourth paragraph on page 1, the manuscript mentions a "lack of methodological rigor" but does not specify which methodological issues are most problematic in current studies (e.g., small sample sizes, lack of control groups). It is suggested to provide concrete examples or supporting data to reinforce this point.

 

RESPONSE 2.2: We thank the Reviewer to highlight this point. We modified the text as suggested (page 4, lines 109-110).

 

In the first paragraph of page 3, it is stated that "translational research is hindered," but there is no detailed explanation of how the checklist tool addresses this issue. It is recommended to elaborate on the specific mechanisms or advantages by which the checklist promotes the translation of research findings into practice.

RESPONSE 2.3: We thank the Reviewer for pointing this out. As suggested, we tried we tried to elaborate more on this point (page 4, lines 116-123).

 

 

3. Methods (Pages 3–5):

In the second paragraph on page 3, the study mentions the use of a "four-round Delphi method," but does not provide details on the objectives of each round or how participant feedback was handled. It is advisable to elaborate on the tasks of each Delphi round (e.g., the first round identifies the structure, the second refines the items, etc.) and to explain how expert opinions were integrated.

RESPONSE 3: We thank the Reviewer for pointing out the lack of clarity in this part. In the amended version of the manuscript, we have tried to make this point clearer (page 5, lines 151-153; page 5, lines 156-160; page 5, lines 170-171; page 6, lines 211-212).

 

 

On page 5, the first paragraph discusses "pilot testing" but does not describe the specific technologies used or the evaluation procedures. It would be helpful to add a case example from the pilot test to improve the transparency and reproducibility of the methodology.

RESPONSE 3.1: The aim of the “pilot testing” phase was to recollect the impression of participant about the experience to use the Checklist, in particular about the four areas reported in the paragraph (Simplicity to use the Checklist; Simplicity to found relevant information to complete the Checklist; competence in Information and Communication Technologies (ICT) needed to use the Checklist; Usefulness of the information obtained using the Checklist). The request was to use the Checklist to judge a health technology (We specified this point in the amended version of the manuscript, page 7, line 254). We agree with the Reviewer that would be helpful to present a case example in this section to improve the transparency and reproducibility of the methodology, but in this specific work we do not recollect information about the specific technologies judged by participant in their use of the Checklist. We mentioned this point as a limit in the discussion session and as a possible element to be improved in future works (page 20, lines 520-526).

 

4. Results (Pages 6–9):

Table 1 on page 6 presents the professional backgrounds and experiences of the participants but does not explain how these backgrounds influenced the checklist development. It is recommended to discuss how the experts’ backgrounds affected item selection (e.g., engineers focusing more on technical feasibility, physicians emphasizing clinical applicability).

RESPONSE 4: We thank the Reviewer for this remark; we specified more on this point in the text and enriched information presented in table 1 (page 10 line 330; page 10 lines 334-336).

 

Table 2 on page 9 lists the revisions and evaluations of the items but does not explain the specific reasons or criteria for modification. It is suggested to provide the rationale for item changes (e.g., vague language, content redundancy) to improve clarity.

RESPONSE 4.1: Done as suggested by the Reviewer (page 11 lines 363-366)

 

5. Discussion (Pages 16–19):

In the second paragraph on page 16, the paper mentions the "practicality of the checklist" but does not discuss its potential limitations (e.g., applicability only to certain types of technologies or elderly populations). It is recommended to address the scope of the tool and possible directions for improvement.

RESPONSE 5: We appreciate the Reviewer’s suggestion. In the Discussion section, in a paragraph devoted to the limitations of the study, we addressed this point and that related to the “pilot testing” mentioned above (page 19, lines 511-512; page 20, lines 520-525).

 

In the third paragraph on page 18, the manuscript refers to "future research" but does not propose any concrete plans for follow-up studies. Suggestions should include clearly defined research directions (e.g., cross-cultural validation, long-term impact evaluation).

RESPONSE 5.1: We thank the Reviewer to highlight this point. We tried to expand this point addressing the previous one on limitations (please see the previous point).

 

6. Formatting and Language Issues:

In the checklist tables on pages 10–15, some item descriptions (e.g., TRL1.1) are overly long and complex. It is recommended to simplify the language or list the content in bullet points to improve readability.

RESPONSE 6: We agree with the Reviewer that some item of the TRL is very long and complex, but we used that scale in its original version and in order to maintain the original format we would prefer not to make any changes in language or structure.

 

There are a few grammatical and spelling errors throughout the manuscript (e.g., in the second paragraph on page 2, “found” should be “find”). A thorough proofreading is advised to correct these minor issues.

RESPONSE 6.1: We thank the Reviewer for pointing this out. We have thoroughly reviewed the manuscript to correct all identified typos, grammar, and syntax errors to ensure the text is accurate and properly structured.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The manuscript has significantly been improved after authors' corrections.

Reviewer 2 Report

Comments and Suggestions for Authors

good revisions.