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Thank you for your thorough revision and detailed point-by-point responses. I have carefully reviewed the revised manuscript alongside the rebuttal letter and am satisfied that all reviewer comments have been fully and appropriately addressed. The reviewer has recommended acceptance at this stage, and I agree that the manuscript is now suitable for publication.
I am pleased to confirm that your manuscript has been accepted for publication in PeerJ. Congratulations, and thank you for your careful work on this revision.
Fine
Fine
Fine
**PeerJ Staff Note:** Please ensure that all review, editorial, and staff comments are addressed in a response letter and that any edits or clarifications mentioned in the letter are also inserted into the revised manuscript where appropriate.
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Table 2 still doesn't report data with a consistent number of decimal places. Otherwise, I am happy with the references, structure, etc.
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The overall reporting is clear, and the literature review is comprehensive.
The study design is appropriate for exploring knowledge, attitudes, and behaviours.
The findings are coherent and broadly consistent with international literature.
**PeerJ Staff Note:** Please ensure that all review, editorial, and staff comments are addressed in a response letter and that any edits or clarifications mentioned in the letter are also inserted into the revised manuscript where appropriate.
**Language Note:** When preparing your next revision, please ensure that your manuscript is reviewed either by a colleague who is proficient in English and familiar with the subject matter, or by a professional editing service. PeerJ offers language editing services; if you are interested, you may contact us at [email protected] for pricing details. Kindly include your manuscript number and title in your inquiry. – PeerJ Staff
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As a significant strength, this manuscript explores the knowledge or skill, attitude, and behaviour towards the implementation of EBP in physiotherapy care. In addition, the physiotherapistís perception of barriers in the implementation of EBP was enquired.
The manuscript has weaknesses, including methodological issues that should be clarified.
In summary, the manuscript is really interesting and innovative, but there are several points that should be clarified. Therefore, my peer review is a major revision in this phase. I wait for the revised version of the manuscript.
AREAS OF AMELIORATION
ABSTRACT:
-Please adopt only MeSh terms as keywords.
TABLES
-Please report all the abbreviations in full in a legend.
GENERAL
-Please report ALL the abbreviations in full in the whole manuscript.
- Please revise the English
INTRODUCTION
-The background and rationale part should be developed more. I suggest improving it accordingly. Please describe what is known and what is missing, and emphasise the importance of your study in the field.
-Add the hypothesis.
METHODS
-reporting: a cross-sectional study must adhere to the international guidelines (STROBE and CHERRIES). Please follow it and consider all the items. I also expect more details on the methods and the completed checklist to be loaded as supplementary. Moreover, you adopted an online administration; thus, you must cite and use the CHERRIES guidelines. What I expect is to follow these guidelines, cite them, fill them, and add them as a supplementary file.
RESULTS:
-findings: please divide the results into sections following STROBE and CHERRIE
DISCUSSION
-I suggest that the authors discuss the main findings by comparing them with the existing literature in other fields, suggesting implications, and analysing strengths and limitations.
The Abstract is not interpretable as a standalone document because: the scoring range of the EBP questionnaire is not stated; and the +/- values are not identified.
An appropriate reporting guideline was followed.
Occasionally, the authors used an incorrect preposition (barriers of EBP, whereas it should be barriers to EBP), but I think this is something the editing service can fix.
The Introduction provides a valid justification for the study.
Ethical approvals were in place.
Using the internet to distribute a survey can help to obtain a large number of respondents, as is seen here. However, a large number of participants is of limited value if they are a skewed (ie, biased) sample. A sample can be shown to be representative if there is random sampling AND a high response rate. The authors started by emailing invitations to IAP members, which had the potential to be a representative sample of IAP members. However, the authors then encouraged snowballing, which certainly does not lead to random or otherwise reliably representative sampling. Furthermore, distribution of the invitation via the internet makes it impossible to calculate the true response rate because we cannot know how many more physiotherapists received the invitation via snowballing. Therefore, the results of the study may be misleading due to unrepresentative sampling. (For future reference, if the authors had done a much smaller random sample of the IAP members and used their resources to chase up non-respondents (eg, resending the questionnaire, email reminders, phone calls), they would have gotten a representative sample if IAP members at least, with a high response rate. As a journal editor (not this journal), I would have found that far more convincing evidence.)
The sample size is adequate from the perspective of statistical power for the regression analysis.
The validity of the findings may be affected by the unrepresentative sampling, discussed above.
About 70% reported being involved in patient care. If the remaining 30% were in research, administration, or education, trying to achieve EBP is not something they would do in their daily work.
Line 209, 210: I don't understand why the authors prevent the overall score of 86.57 (SD 9.13), ie, the sum of all item scores and the mean score of 3.61 (SD 0.38), ie, the average per item (sum ÷ number of items). This is just the same information presented on a different scale. The authors should choose a scale and just present it once.
The authors seek to infer causation from their cross-sectional data, which they should not do. For example, "demonstrates that better attitude and knowledge would lead to behavior of EBP.". This is not a valid conclusion from cross-sectional data. Similarly, "had more influence on the knowledge score" also inappropriately implies causation.
P-values are being replaced by confidence intervals, as confidence intervals are more informative and lack some of the inherent limitations of P-values. The CI gives more information than the p-value alone because it shows the plausible range of the true correlation in the population. Therefore, in the text where correlation coefficients are reported with P-values, the authors should consider reporting confidence intervals instead of p-values.
Decimal places are inconsistent, eg, in the abstract, the mean years of work experience was presented to two decimal places, and SD was presented with one decimal place. No decimal places should be reported unless decimal places were measured in the raw data.
The findings are not especially novel. See the systematic review by Paci et al, which shows that many studies have found knowledge, time, skills, resources, etc, are barriers to EBP in physiotherapy.
The manuscript is clearly written and professionally presented. The overall English is understandable, but some sentences are lengthy and could benefit from minor editing for conciseness and clarity (e.g., lines 74-105 and 250-270). A professional language edit is recommended to improve readability for an international audience.
The background is generally well developed with sufficient references to highlight the importance of EBP in physiotherapy. However, some references are dated 20 years back, such as (Rosenberg& Donald, 1995; Sackett et al., 1996). More recent literature (past 5 years) could be highlighted.
The structure follows a conventional research article format (Abstract, Introduction, Methods, Results, etc). The article is self-contained, with results clearly linked to the stated aims.
The study design (cross-sectional, online survey using EBPQ and perceived barriers scale ) is appropriate for the research aim. The choice of a large sample ( n= 2,996) strengthens the statistical result/power. Ethical approval is reported, and the study was prospectively registered. Online informed consent was obtained. Methods are described in reasonable detail; however, the description of the sampling strategy raises some concerns. The use of both IAP limitation lists and snowball sampling could introduce selection bias. This limitation should be emphasized more explicitly.
The EBPQ instrument is widely used and reliable. Cronbach's alpha values are cited. However, the justification for its direct transferability to Indian physiotherapists could be expanded.
The findings are supported by adequate statistical analyses (Descriptive, correlation, and regression). Results are presented clearly in both text and tables. The large sample size and high power ( post-hoc power analysis reported as 1.00) increase confidence in the findings.
1. Language editing is needed for clarity and conciseness
2. The imbalance in geographic representation (very few from Eastern India) should be discussed more explicitly as a limitation.
3. Provide more detail on how to duplicate responses that were prevented in the online survey.
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