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Publication of Evaluation Studies: Challenges & Guidelines for authors

Publication of Evaluation Studies: Challenges & Guidelines for authors. Elske Ammenwerth UMIT - University for Health Sciences, Medical Informatics and Technology, Hall, Austria elske.ammenwerth@umit.at. Organisers.

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Publication of Evaluation Studies: Challenges & Guidelines for authors

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  1. Publication of Evaluation Studies: Challenges & Guidelines for authors Elske Ammenwerth UMIT - University for Health Sciences, Medical Informatics and Technology, Hall, Austria elske.ammenwerth@umit.at

  2. Organisers • EFMI Working Group „Assessment of Hospital Information Systems“ (http://iig.umit.at/efmi) • IMIA Working Group „Technology Assessment and Quality Development in Health Informatics“

  3. Motivation • Increasing reports on problems with IT in health care • Insufficient integration into clinical workflow • Insufficient integration between IT systems • Usability problems • Danger of errors caused or increased by IT • Low user acceptance, user boycott • Project failures • Loss of money, loss of reputation • Bad Health Informatics can kill: Examples where insufficient IT system can hinder processes and harm patients • Examples at: http://iig.umit.at/efmi/

  4. Need for Evaluation: Declaration of Innsbruck • Evaluation contributes to better IT systems in health care • Evaluation support continuous monitoring and review of IT • Evaluation is an ethical imperative • To detect problems as early as possible • To learn from problems and errors • To steadily improve IT systems • To contribute to better health care • Ammenwerth E, Brender J, Nykänen P, Prokosch H-U, Rigby M, Talmon J, et al. Visions and strategies to improve evaluation of health information systems Reflections and lessons based on the HIS-EVAL workshop in Innsbruck. Int J Med Inf. 2004 Jun 30;73(6):479-91.

  5. Evidence-Based Health Informatics • IT systems in health care largely affect quality and efficiency of health care • All decisions with regard to IT systems should be grounded on best available evidence! • Example: Hospital considers introducing a CPOE system • What is the available evidence? • What will be the benefit? • Which side effects may occur? • How to best introduce the CPOE system? • What are the costs?

  6. EBHI is based on publications • Evidence-Based Health Informatics aggregates available evidence • Systematic review: Descriptive collection of evidence • Example: „11 from 15 studies on CPOE show a significant reduction of medication errors“ • Meta-Analysis: Mathematical aggregation of available evidence

  7. Need for publication • Evidence-Based Health Informatics is only possible sufficient high-quality evidence is published! • IT evaluation studies should be published • Publications should be of high quality (complete, clear, …) • Publications should be available and searchable

  8. Challenges • Evidence-based health informatics is based on publications: • How much evaluation studies are un-published? • Many publications are of low quality: • How to write a „good“ evaluation paper?

  9. Programm of workshop • Introduction: Evidence-based health informatics and publication • Publication bias in health informatics: How many studies are published? Why are studies not published? • STARE-HI - Guidelines for authors: What information should be contained in a publication of an IT evaluation? • Summary and Conclusion

  10. 2. Publication Bias • What is publication bias? • Survey on publication bias • How to detect publication bias?

  11. Publication bias Occurs when research that is readily available differs in its results from all the research that has been done in the area. [Rothstein et al 2005] Publication bias is the tendency on the parts of investigators, reviewers and editors to submit or accept manuscripts for publication based on the direction or strength of the study findings. [Dickersin 1990]

  12. Publication bias • Studies have a larger chance to be published when they show a significant results, i.e. a positive effect of the evaluated IT system • Authors (often involved in the project!) may not want to present unsuccessful implementations. • Editors may favour studies showing an interesting (positive) effect.

  13. Publication bias in context Publication bias and other related biases can be summarised as statistically significant, 'positive' results being: • more likely to be published (publication bias) • more likely to be published rapidly (time lag bias) • more likely to be published in English (language bias) • more likely to be published more than once (multiple publication bias) • more likely to be cited by others (citation bias) [The Cochrane Collaboration]

  14. Publication bias • The problem with publication bias: • The published evidence is systematically biased towards positive results! • Reviews and meta-analysis are based on published evidence and thus will come to biased conclusions!

  15. Questions • How many IT evaluation studies are NOT published? • What are reasons for not publishing? • Is there a bias towards positive findings = publication bias?

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