EVALUATING THE BMJ GUIDELINES ON ECONOMIC SUBMISSIONS: PROSPECTIVE AUDIT OF ECONOMIC SUBMISSIONS TO THE BMJ AND THE LANCET

Tom Jefferson, Richard Smith, Mike Drummond, Rajendra Kale, and Yunni Yi (United Kingdom)
Army Medical Directorate, Keogh Barrachs, Ash Vale, Hants GU125RR, UK; BMJ, London, UK; University of York, UK

Objective: To assess whether publication (in August 1996) of the BMJ guidelines on peer review of economic submissions to the BMJ and The Lancet made any difference to (a) ease of editing and carrying out the peer-review process; (b) quality of submitted manuscripts; and (c) quality of published manuscripts.

Design: Review of manuscripts before and after publication of the guidelines. All submissions with an economic content (those making explicit comments about resource allocation and/or costs of interventions) submitted during the periods of July 1 through September 30, 1994, to the BMJ and October 1 through December 31, 1995, to the BMJ and The Lancet were included in the "before" phase of the study. Submissions to the BMJ and The Lancet in the period of April 1 through July 1, 1997, were enrolled in the "after" phase of the study. Characteristics of the submissions will be compared for both phases.

Results: We classified the submitted manuscripts as economic evaluations (in which analytical methods are used to analyze alternatives for resource allocation); economic studies (partially analytical reports, ie, cost-outcome studies, descriptive and methodological papers); economic papers (reports with minimal economic input, ie, submissions containing 1-line mentions of cost, editorials, non-systematic reviews, letters, and opinion pieces). Overall, 2,975 manuscripts were submitted to the 2 journals during the "before" study phase; 106 of which were economic (3.56%; 95% CI, 2.92%-4.29%). Of these 37 (34.9%; 95% CI, 25.0%-44.0%) were economic evaluations, 49 (46.2%; 95% CI, 36.7%-55.7%) were economic studies, and 20 (18.8%; 95% CI, 11.4%-26.3%) economic papers. Overall, 13 (12.3%) of 106 were accepted (95% CI, 6.0%-18.5%). Of the 11 (29.7%, 95% CI, 15.9%-47.0%) economic evaluations that were peer reviewed, 7 (18.9%; 95% CI, 7.97%-35.2%) were accepted for publication. Of the 16 (32.7%; 95% CI, 20.0%-47.5%) economic studies that were peer reviewed, 6 (12.2%; 95% CI, 4.6%-24.8%) were accepted for publication. Of the 8 (40%; 95% CI, 19.1%-63.9%) economic papers that were peer reviewed, nil were accepted for publication. There appeared to be little difference between the 2 journals in terms of numbers or editorial fate of the manuscripts.

Conclusions: Major medical journals are sent an array of different types of submissions with an economic content, most of which do not reach publication. Publication of the guidelines with the checklist and editorial manuscript management path should help editors, peer reviewers, and authors to rationalize the process.

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