PONE-D-20-00517

Sick of news? Television news exposure and headache related emergency department visits

PLOS ONE

Dear Dr. waismel-manor,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

The manuscript has been evaluated by three reviewers, and their comments are available below.

The reviewers have raised a number of concerns that need attention. The reviewers have suggested changes to the abstract and further details regarding the primary outcome measure. As reviewer #1 notes, the study cannot disentangle the effects of watching the news and stressful events occurring within the community. Since either could explain the results, the title should be revised and this limitation addressed in the Introduction and Discussion sections. Regarding the title, my recommendation would be to remove “Sick of news?”.

Could you please revise the manuscript to carefully address the concerns raised?

Please submit your revised manuscript by Aug 24 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

We look forward to receiving your revised manuscript.

Kind regards,

George Vousden

Senior Editor

PLOS ONE

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We will update your Data Availability statement on your behalf to reflect the information you provide.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Yes

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: This manuscript presents the ecologic association of television news ratings and emergency department visits for headache in a tertiary care hospital in Israel. Headache visits were found to be slightly more common on the day following a day with higher television news ratings. The association was slightly stronger among older adults.

Television news ratings seem to be conceptualized as both a marker of community stressful events and as a potential cause of stress. It would be helpful to state this more clearly in the introduction. Given the inability to differentiate between the two possible mechanisms, I would revise the title.

Please provide more detail on how primary complaint of headache was identified. Is this based on a standardized coding system?

It would be helpful to formally test for interaction of news ratings with age and gender.

It is not clear to me what exactly is presented in Supplemental Figures 1 and 2.

I did not have access to the supplemental table to review.

Line 219. Please elaborate on the unique aspects of media consumption in Israel.

Reviewer #2: This study evaluated the association between news category and ER headache visit. The authors found that an increase in five units of daily rating percentages was associated with increase in Emergency Department visits the following day. I am hoping to comment several points.

1. The authors described that they categorized headline news by category. However, there was only few descriptions for "increase in 5 units of daily rating percentage". Consider revision for more description for this issue at METHODS for better under standing

2. The authors analyzed the association between all headaches and news contents. Two common primary headaches, migraine and tension-type headache, have different triggering factors in addition to clinical differences. Therefore, migraine and TTH may show different pattern to stressful news. It would be more valuable if additional analyses for the difference in the association between ER headache visit and stressful news. If it is not possible, consider additional description as a limitation of this study.

3. One of limitation of this study is the setting of the study. The data of this study were collected in a single university hospital in Israel. Therefore, it is difficult to generalize. This could be a limitation of this study.

4. Trivia. Decimal point issue. Some decimal points were needed to revise collectively. 41.25±18.6 -> 41.3±18.6.

Reviewer #3: The authors examined the relation between TV news and emergency department visits because of headache.

The study covered almost a decade and included a total of 16,693 emergency department visits.

The study is interesting, but study objectives and methods require more clarity and the authors should avoid selective reporting in the abstract.

In the abstract and in the introduction, the authors should specify the objectives of the study, namely to analyze the relation between emergency room visits because of headache and (1) the daily rate of persons watching TV news and (2) the content of the news.

Throughout the paper, the authors should avoid phrases such as “rating percentages”. Such terms are ambiguous and leave open what the rating refers to.

The lack of an association between news content and emergency room visits because of headache must be reported in the abstract.

The low rate of TV news consumers (less then 30 %) should also be reported in the abstract and mentioned in the discussion.

In the abstract and in the results, the authors should check following finding, “This association increased with the age of the patients; RR =1.119, (95% CI 1.014; 1.050) …“ The confidence interval cannot be smaller than the RR.

In the paragraph on the limitations of the study, the authors should replace the general statement, “Our ability to understand the interaction between media consumption, collective stress and headache in relation to the different news contents is limited” by a statement specifically related to their study such as, “Our study does not allow conclusions about the interaction between media consumption, collective stress and headache.”

The English text needs some editing.

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6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

Reviewer #3: Yes: Prof Çiçek Wöber-Bingöl, MD

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PONE-D-20-00517R1

Sick of news? Television news exposure, collective stressful events and headache related emergency department visits

PLOS ONE

Dear Dr. waismel-manor,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Mar 21 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

We look forward to receiving your revised manuscript.

Kind regards,

Junaid Ahmad Bhatti

Academic Editor

PLOS ONE

Additional Editor Comments (if provided):

The revised version has received favorable reviews. Kindly revise the manuscript as per the suggestions for minor revisions.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

Reviewer #3: No

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

Reviewer #3: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The authors properly addressed all the points mentioned in the previous review. The authors also adequately revised the manuscript after the previous review.

Reviewer #3: The authors followed the reviewer's suggestions. Only one sentence in the abstract and results still needs revision.

"This association increased with the age of the patients; RR =1.119, (95% CI 1.075; 1.065) for older than 60-year-old, RR=1.044 (95% CI 1.010-1.078) for ages 40-60 and RR= 1.000 (95% CI 0.977-1.023) for younger than 40-year-old.

There is still a problem with the 95% CI in the older persons!

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No

Reviewer #3: Yes: Prof Çiçek Wöber-Bingöl, MD

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Sick of news? Television news exposure, collective stressful events and headache related emergency department visits

PONE-D-20-00517R2

Dear Dr. waismel-manor,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Junaid Ahmad Bhatti

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments: