Step 6: Communicate the Findings
Dissemination of findings is an important objective of economic evaluation, but one that requires careful planning. It can be difficult to determine which publications to target for economic evaluations. The decision as to where to publish findings is perhaps best made by considering the perspective of the study, since journals or other publications which target that perspective would be a logical priority. For example, evaluations taking the health plan perspective could be targeted toward managed care or health care benefit-focused journals. Evaluations taking a health system perspective may be best targeted toward journals that target health systems. Evaluations taking societal perspectives may be best suited for population health- focused journals, where the broad costs and effects of treatment are of interest. Newsletters, blogs, social media, and trade magazines are other potential outlets for cost research.
If pursuing publication in an academic journal, careful consideration should be given as to which journal best fits the material. The journal should either indicate that economic evaluations are of interest or have a submission category specific to health economic studies. Table 18.5 provides a short list of criteria that can be used to evaluate a journal’s fit for the economic evaluation. Additionally, a number of credible checklists can serve as a guide to developing a cost-related publication (Drummond & Jefferson, 1996; Husereau et al., 2013a, 2013b; Siegel et al., 1996). Most recently, the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was developed and jointly published by several journals (Husereau et al., 2013a, 2013b). Recommendations are summarized in a 24-item checklist that guides the authors on the key elements of cost papers, including the title, abstract, introduction, objective, methodological aspects (e.g., the comparators included, time horizon, cost and effectiveness measures, assumptions, and presentation of results).
While these checklists are helpful in guiding the content of health economic papers, crafting these manuscripts is very much an art. Assuming the necessary information is contained, it must be packaged well, by incorporating graphical depiction of Consolidated Standards of Reporting Trials (CONSORT) statements (for clinical trials), and assumptions must be detailed and referenced (including for the sensitivity analysis, a table specifying base case assumptions, ranges tested, distribution of the ranges tested, and source of the ranges tested). Often, the word count of health economic manuscripts exceeds journal limits, necessitating placement of selected methods and results in an appendix.
Finally, the importance of a clear and compelling discussion in economic papers cannot be underestimated. The meaning of findings must be clearly articulated
TABLE 18.5 Factors to Consider When Identifying Where to Submit Economic Evaluations
- ? Cost or cost-effectiveness is stated in the journal's scope of interest.
- ? Instructions for authors include a submission type that fits cost papers.
- ? Examination of the journal's publication history indicates a track record of publishing cost papers.
- ? The journal allows submitters to recommend reviewers.
on the basis of the perspective chosen for the economic evaluation. The discussion section should answer the following questions: For cost-effectiveness studies, is the treatment cost-effective on the basis of expected willingness to pay values? Should the treatment be adopted? If so, for all or for select subgroups? How do the cost findings compare to other studies? Are the limitations completely and candidly acknowledged, in particular, limitations posed by the data sources and assumptions? Finally, conclusions should be consistent with the results presented, without presumption.