Open Access Biomedical Publisher Using Post Publication Peer Review
Since it is a research protocol, I don't expect conclusions at this stage. I cannot evaluate the length of the paper, tables and illustrations.
The Design and Methods section probably can be reduced and focused on the paper issue.
1) It is not clear what does it mean "adaptation capacitating of categories ACG": The objective of the study must be clarified.
2) Once it is clarified, the authors must also clarify how they will evaluate the "adaptation". From the research protocol, it is not clear wich measures they use.
3) Design and Methods, Main measures:
- Implicitly the authors describe a model: What do they try to do through this model?;
- They define as dependent variable one that is tipically independent: care episodes.
- Total costs are considered dependent as well as "additional" (independent?) variable: it is not consistent.
4) Design and Methods, The ACG Risk Adjustment System:
- Charlson Index is cited as a proxy to patient severity, but it is not included in the statistical analysis proposal
5) Design and Methods, statistical analysis:
- The authors propose three models of linear regression; in the third one they use "number of episodes" as independent variable: Does episodes mean diagnostics?; why they don't use ACG group as independent variable?
1) English must be improve (e.g. "realized" means really "developed"; it is a direct translation of Spanish and does not mean the same in English).
2)The paper needs further revision of formal contents: There is a duplicated paragraph in the Discussion section.
Use of casemix systems in healthcare
MAJOR ISSUES1.The article is missing Results or a Conclusion. It reads as a project proposal and not a completed research study. It would be advantageous to present the results or wait until the study has been completed before publishing. In this regard, the “Study timeline” is not needed.2.There is confusion raised by the use of the word “episodes”. a.Under “Main measures” “care episodes” are listed as a dependent variable. These are “quantified according to the International Classification of Primary Health”. This creates an endogenous model when at the same time, one of the independent variables “b) case-mix or co-morbidity” which is defined as “b) the individual case-mix index, obtained by the ACG.”b.Under “Statistical Analysis” the third model of linear regression is described as using “age, sex and number of episodes” as the independent variable. If “number of episodes” is to be a measure of morbidity then it is not a number, nor is it episodic.3.The authors talk about “Adaptation” (under “Discussion”) yet there is no explanation of what adaptations were undertaken. 4.The authors incorrectly describe the ACG System in the “Background”. The ACG System does not classify “individuals according to the diseases that they present” but by the patients’ diagnoses. 5.Similarly, the ACG System’s major objective is not “to measure the degree of disease”, but “to measure the degree of morbidity.”6.The authors need to acknowledge that the use of the ICPC Coding System is not legally licensed in Spain.MINOR ISSUES7.The title has several errors. a.“Johns Hopkins” does not contain a hyphen.b.The ACG System is not the “ACG Case-Mix System”. And a copyright symbol needs to be attached the first time it occurs in the manuscript.c.“Categories” should be deleted from the title.8.The article needs to be edited by a native English speaker. Several sentences are unclear.9.Under “Design and study setting” the text is written in both future (i.e. “will be”) and past (i.e. “consisted”) tense.10.“The ACG Risk Adjustment System” contains the following issues:a.“ICD-9-MC” should be “ICD-9-CM” since the article is written in English.b.“This method provides the United States of each group with respect….” makes no sense.c.The sentence mentioning the Expanded Diagnosis Clusters should be deleted since the EDCs have nothing to do with this study.11.Under “Models of cost….” The authors refer to “semi-fixed costs” in their formula for cost per patient, yet these are never defined.12.Also, the formula for cut-off point (T) is incorrect13.Under “Discussion” the first sentence is repeated in the second paragraph.
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