Design of Open Code Software to Downs and Steiner Lateral Cephalometric Analysis with Tracing Landmarks

Round 1

Reviewer 1 Report

 

Dear Authors,

Thank you for submitting your article to this prestigious journal.

The manuscript is well presented but it presents some issues:

 

Abstract: Abstract should be revised and make it more appealing.

 

Keywords: To ensure a properly research in medical databases, use MeSH terms to find  appealing keywords that could be helpful in finding your article.

 

“Octave is an open-source software focused on the application of mathematical vector 34 and matrix operations. It applied initially in several undergraduate and graduate courses 35 in the Chemical Engineering Department at Texas University. The math department at 36 the university has been using it for teaching differential equations and linear algebra 37 [8]. The designed software, Cephalopoint, is a set of instructions applying the Octave 38 commands. “ Are Octave and the other software explained in the introduction registered marks and protected by some certifications?

Introduction should be revised to focus the attention to the AIM of this manuscript. Moreover introduction is too short please extend it.

Why does the authors choose the, Shapiro-Wilk test (W)? Does any descriptive statical analysis have been performed? Do the authors calculate the Kurtosis?

 “In the present study, Downs and Steiner analysis norms were used to design a software program. The results were compared with manually tracing. This comparison demonstrated that our designed software had a very high similarity with conventional tracing.” Please be more specific and cite more studies.

Discussion seems a repetition of the RESULT section please modify

Conclusion must be entirely revised making it more appealing and expanded.

English spell revision is necessary.

 

Check if it necessary the references section. (For e.g. PMID is not necessary). And if it possible reduce the number of the references.

 

 

Best Regards.

Author Response

Point 1. Abstract: Abstract should be revised and make it more appealing.

Response 1. The Abstract was revised and rewritten.

Point 2.  Keywords: To ensure a properly research in medical databases, use MeSH terms to find  appealing keywords that could be helpful in finding your article.

Response 2. The new keywords are Clinical Analysis; Software Validation; Cephalometry.

Point 3.  Are Octave and the other software explained in the introduction registered marks and protected by some certifications?

Response 3. The source code for Octave is freely redistributable under the terms of the GNU General Public License (GPL) as published by the Free Software Foundation. Cephalopoint is free software created for this study and without commercial interest. 

Point 4. Introduction should be revised to focus the attention to the AIM of this manuscript. Moreover introduction is too short please extend it.

Response 4. The introduction was revised and extended.

Point 5. Why does the authors choose the, Shapiro-Wilk test (W)? Does any descriptive statical analysis have been performed? Do the authors calculate the Kurtosis?

Response 5. The Shapiro-Wilk test was chosen to determine the normal distribution of a variable with a low number of samples and was considered suitable for the study. It was not considered necessary to carry out the descriptive static analysis because, in other articles where a comparison of manual tracking with other software was also made, it was not carried out. In the modified article, kurtosis was already applied to confirm the normal distribution (Mesokurtosis).

Point 6.  “In the present study, Downs and Steiner analysis norms were used to design a software program. The results were compared with manually tracing. This comparison demonstrated that our designed software had very high similarity with conventional tracing.” Please be more specific and cite more studies.

Response 6.  In the section of Discussion, the information was extended and more studies were cited.

Point 7. Discussion seems a repetition of the RESULT section please modify

Response 7. In the modified article, in the section of Discussion compared with other studies, described the future work of the software, and commented about the social impact of the software on the low-income dentists. 

Point 8. Conclusion must be entirely revised making it more appealing and expanded.

Response 8. The conclusion section was rewritten in the modified article, the information was supported by the Results section.

Point 9. English spell revision is necessary.

Response 9. English spell was corrected.

Point 10. Check if it necessary the references section. (For e.g. PMID is not necessary). And if it possible reduce the number of the references.

Response 10.  A few of the references were removed but many other references were added to back up the statistical description and discussion.

Best regards

Reviewer 2 Report

Dear authors,

 

Thanks for your kind submission and for giving me the opportunity to review it for me, below you will find my suggestions and comments to improve the quality of your maniscript:

 

The introduction and generally the manuscript is very academic, the scientific background and soundness should be improved by the authors,

Also, it is not clear to me: does the new software operates with octave? Is it available on a platform or should be downloaded by the users? As a freeware?

 

Author Response

Point 1. The introduction and generally the manuscript is very academic, the scientific background and soundness should be improved by the author.

Response 1:  I changed some parts of the document to the scientific background.

Point 2. Also, it is not clear to me: does the new software operates with octave? Is it available on a platform or should be downloaded by the users? As a freeware?

Response 2. Cephalopoint is an Octave's Library formed by 4 codes, 2 for Steiner's Method and 2 for Downs' Method. The software is freeware. To download the software is availed on https://sites.google.com/upaep.mx/cephalopoint/about

Point 3. Also, it is not clear to me: does the new software operates with octave? Is it available on a platform or should be downloaded by the users? As a freeware?

Response 3. Cephalopoint is an Octave library formed by 4 code files, and the files are downloaded at the following link:  https://sites.google.com/upaep.mx/cephalopoint/download

 All code files run on Octave. The software is under the terms of the GNU Generic Public License as published by the Free Software Foundation.

Best regards.

J.J. Reyes-Salgado

Reviewer 3 Report

Thank you for submitting your manuscript to mdpi. The topic of providing open-source cephalometric software for students is welcome. After reading - there remain some serious concerns. 

• the abstract is not well structured and lacks information about the results
• you write the time was significantly reduced, this is probably true, but I see no measurements.
• the citation of the GNU Octave software is not correct and version information is missing
• why did you choose GNU Octave? It is a useful tool, however, but there are much better alternatives for such a project like python with libraries numpy, scipy, etc.
• there is no user interface this could be easily added with uicontrols / uigetfile in Octave, the calculations of angles and distances are nice math ;-).
• after some search, I found the source code. For an open-source project, the code has to be much better documented and structured.  The link is not available in the publication!
• a clear hypothesis is missing
• important information about the methods are missing, which statistical software was used, investigators are taken in to account in the discussion - it belongs to m&m. 
• the statistical analysis remains neboulus. For inter- or intrarater reliability ICC according to Shrout&Fleiss is standard
• Bland-Atman-statistics are missing - it's more than the graphs
• the discussion is no discussion - the reliability and precision have to be discussed in relation to previous studies or software systems
• in the appendix you write about converting into bitmap? the code doesn't do this and it is not necessary (Appendix A.1)

Sorry for the harsh comments, to my understanding the paper has to be completely rewritten, and the statistics improved substantially.  

Author Response

Point 1. The abstract is not well structured and lacks information about the results.

Response 1.  The abstract was modified to be more structured and show more information on the results.

Point 2. You write the time was significantly reduced, this is probably true, but I see no measurements.

Response 2. The time test was well explained, and the results were more detailed in the article modified.

Point 3. the citation of the GNU Octave software is not correct, and version information is missing

Response 3. The citation was corrected and informed about the Octave version used in the study.

Point 4. Why did you choose GNU Octave? It is a useful tool, however, but there are much better alternatives for such a project like python with libraries numpy, scipy, etc.

Response 4. The main reason for using Octave was easy programming, and it is the most programming language used by the  Mathematics department in the Engineering Faculty. Eventually, I hope other colleagues will join the project.

Point 5. there is no user interface this could be easily added with uicontrols / uigetfile in Octave, the calculations of angles and distances are nice math ;-).

Response 5. The user interface was generated using Dialogue Boxes waiting for an answer, displaying the image, and using the command ginput to select the points on the picture. The modified paper was detailed more about it.

Point 6. after some search, I found the source code. For an open-source project, the code has to be much better documented and structured.  The link is not available in the publication!

Response 6. The link was corrected, and the modified article explained in more detail the code.

Point 7. a clear hypothesis is missing

Response 7. It was corrected.

Point 8. important information about the methods are missing, which statistical software was used, investigators are taken in to account in the discussion - it belongs to m&m. 

Response 8. You are entirely right about this. The missing information was introduced in the corresponding section.

Point 9. the statistical analysis remains neboulus. For inter- or intrarater reliability ICC according to Shrout&Fleiss is standard

Response 9. The statistical analysis was extended and more detailed in the section of Materials and Methods. I used Bland-Altman analysis to compare manually and software techniques because in several clinical papers this method is the most accepted.

Point 10. Bland-Atman-statistics are missing - it's more than the graphs

Response 10. It was corrected and detailed more analysis in the Results section. 

Point 11. the discussion is no discussion - the reliability and precision have to be discussed in relation to previous studies or software systems

Response 11. It was modified.

Point 12. in the appendix you write about converting into bitmap? the code doesn't do this and it is not necessary (Appendix A.1)

Response 12.  I think is necessary because the software load the picture, it creates a variable matrix with the RGB information, and when the user selects the point the software returns the coordinate of the matrix. So I can explain why the coordinate values ​​are obtained, being necessary to make a conversion to distance units. However, if after reading this argument and you think that it is not entirely necessary, I am open to suggestions and only will comment it where it is needed.

Point 13. Sorry for the harsh comments, to my understanding the paper has to be completely rewritten, and the statistics improved substantially. 

Response 13. I don´t have any problem and I am ready to the critic. I appreciate your time invested in reviewing the paper. The modified paper was organized and extended considering all the points of view of the reviewers.

 Best regards,

J.J. Reyes-Salgado

Round 2

Reviewer 1 Report

Dear Author, 

I think after suggested changes the article will be suitable for publication. 

Comments for author File: Comments.pdf

Author Response

Point 1. The abstract should be rendered schematic following the MDPI guidelines.

Response 1. The abstract was changed to follow the MDPI guidelines. Write in one paragraph without headings, and following the structure: 1) Background ... 2) Methods ... 3) Results ...   4) Conclusion.

Point 2.  this evaluation, which I believe to be absolutely correct, in my opinion requires an addition concerning the possibility of carrying out and planning orthodontic treatment or orthognathic surgery with the aid of software programs such as TFA, which I consider innovative and absolutely inherent to this research, and which I recommend to include in the introduction to enrich it from this point of view:

Response 2. This point of view was included in this paragraph.

Point 3. In the materials and methods:   Figure 2. ... Please insert this
image.

Response 3. I didn't understand, because you refer to figure 2. If it didn't mention in the document, if this is the case it could be found in line 96.

"The logic used to program Cephalopoint is described by the following flowchart diagram, as shown in Fig. 2."

or if it is the jpg figure that didn´t show in the document. The following picture shows as seen in the paper.

https://drive.google.com/file/d/1yLw984JNFvUYneut9eB77q9eSbhz4eT6/view?usp=sharing

In the case of being something different, I am attentive to your recommendation

My best regards, I appreciate your comments and the time invested with the document.

Reviewer 2 Report

Dear authors thanks for following my suggestions/comments, I have no further observations.

Author Response

My best regards, I appreciate your comments and the time inverted in the document.

J.J. Reyes Salgado

Reviewer 3 Report

Thank you for resubmitting this paper. There are a lot of improvements and the manuscript is ready for publications.

Author Response

My best regards, I appreciate your comments and the time inverted in the document.