AcademyHealth Annual Research Meeting: Publish or Perish? Meet the Editors Part One Patrick S. Romano, MD MPH Co-EIC, Health Services Research (HSR) June 2018
Meet the Editors • Patrick S. Romano, MD MPH – Co-editor in Chief, Health Services Research – Professor of General Medicine/General Pediatrics, UC Davis School of Medicine (Sacramento) • Jeroan Allison, MD, MS – Co-editor-in-chief, Medical Care – Professor/Vice Chair, Dept. Quantitative Health Sciences, University of Massachusetts Medical School • Arnold Epstein, MD MPH – Associate Editor, New England Journal of Medicine – Professor and Chair, Dept. of Health Policy and Management, Harvard T.H. Chan School of Public Health
Meet the Editors • Preeti Malani, MD MSJ – Associate Editor, JAMA – Chief Health Officer and Professor of Medicine, University of Michigan • Denys Lau, PhD – Associate Editor, AJPH – Director, Division of Health Care Statistics, CDC National Center for Health Statistics
Objectives • Describe missions of different journals, i.e. “what we publish” and why • Improve participants’ understanding of the peer review process • Improve participants’ likelihood of success in navigating the submission, review, and revision process
Specific targeted areas of research • Issues related to the delivery of care — access to and utilization of health services; cost, cost-effectiveness, quality, and outcomes of care; practice variations, technology assessment, and workforce… • Assessments of the impact of or changes in specific policies and interventions on health care delivery — Medicare and Medicaid, state health policies and regulations, payment policies, personnel licensure and certification, and antitrust enforcement; • Evaluation of national demonstration programs — particularly focusing on disease prevention, chronic disease management, and community-based efforts to integrate services or promote health; • Examinations of changes in health services organizations, systems of care, managed care, and related developments , including comparisons of systems across nations ; and • Examinations of the relative importance of biological, behavioral, social, and political factors, in addition to health care, as determinants of health outcomes .
Examples of ‘Fit’ for HSR • Implications: • Audience: Papers should have clear Disciplinary and implications for policy or multidisciplinary policy-relevant research researchers Focus on systems for Methodologists organizing, providing, Policy analysts governing, financing, or Mostly U.S.-based but regulating care (rather with a global context than specific choices in providing care) Not primarily clinicians or health care Methodologic rigor administrators MULTIDISCIPLINARY
Manuscript types • Full-length research articles deal with important empirical issues involving health and health services. • Research briefs involve incremental contributions to the literature such as validation or extensions of previous work, single-setting studies, or case studies. • Methods articles and briefs focus on contributions involving the development of new methods and tools, the application of current methods in novel ways, and examination of the pros and cons of using different methods and tools in particular study situations and empirical settings. (Methods Corner SOLICITED) • Policy impact articles are thoughtful essays on the impact of HSR on decision makers, the overall relationship between HSR and users of research, or the impact of specific HSR initiatives… • Debates/Commentaries feature pro and con views on important, controversial health services or policy issues or commentary on an article in the issue (Editorials SOLICITED).
Preparing Your Manuscript • Follow guidelines! • http://hsr.org/hsr/information/authors/ instrucauthors.jsp • Consider yourself as a chef trying to impress your customers with the freshness of your ingredients and the quality of your presentation • Electronic process: https://mc.manuscriptcentral.com/hsr • Disclose COI, prior publication, concurrent reviews • Avoid salami science, meat extenders
What We Do First • Managing Editor assigns the manuscript to an editor-in- chief [EIC] based on workload 884 new MS/year* and potential COI (N=2) • EIC reviews to determine 293 external whether the manuscript goes review/year* out for peer review – “Lack of fit” with the journal – Narrow potential audience – Obvious quality problem • Average of 65% EIC rejections, mean time to * 2017 regular issue decision 10 days submissions
Identifying Reviewers • EIC assigns paper to an SAE (N=11) to shepherd the review process and identify >2 reviewers, who as a set have the needed expertise (often different disciplines) • Identifying willing and appropriate reviewers is difficult (often the longest pre-decision stage) • Use database to track reviewer quality and timeliness • Authors can help by suggesting potential reviewers (with e-mail); we usually try to get one of these • CAN suggest whom not to use; authors should explain why because we may not follow these suggestions…
Reaching a Decision • Reviewers’ comments go to SAE • SAE re-examines the full record [paper and reviews] and recommends a decision & comments for authors • The EIC who started the process makes the final call & ratifies SAE recommendation • EIC sends letter to the author with decision, advice, and reviews: major revise, minor revise, reject • Mean time to first decision 94 days (down from 107-115 days)
Revisions and Responses • Editors try to resolve differing recommendations from reviewers • Slavish revisions may be inappropriate – It’s your paper and we may have “gotten it wrong” – But, if we did, readers might also be “confused” • Detailed memo explaining how you addressed each point is helpful • Electronic appendices • Keep in touch with us!
Typical Problems • Abstract is inconsistent with manuscript or omits specific (numeric) findings • Introduction misses key studies, “previews” results • Conceptual framework missing or inadequate • Analytic methods are poorly described, unclear • Results just repeat tables or (alternatively) do not properly represent tables/figures • Discussion has biased review of prior studies, inadequate discussion of limitations • No policy implications or (alternatively) overselling findings with limited generalizability • Misleading or uninformative graphics (bar/pie charts)
Decisions, Decisions! • Revisions go back to SAE • Sometimes an immediate decision, but usually back to at least one reviewer if major revisions • Then back to SAE and EIC • Overall acceptance rate 18% (38% US) – 11% of REVISED papers are rejected – 52% of R1 manuscripts sent back with minor revise or conditional acceptance • Mean 81 days from acceptance to online publication/indexing
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