Development of an objective assessment tool for appraising reporting quality of economic evaluations with the Consolidated Health Economic Evaluations Reporting Standards 2022: The CHEERS framework

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However, it holds multiple criteria per item without clear decision rules on minimum requirements for complete reporting, which introduces subjectivity. The purpose of this study is to present the CHEERS framework, based on CHEERS 2022, a tool which enables an objective yet comprehensive quality appraisal of EEs. Method The framework was developed by translating the CHEERS 2022 explanations into decision rules, adding Boolean operators to separate multiple criteria as well as highlight decision options. Some decision rules were supported by defining “minimal” and “comprehensive” requirements. Piloting occurred during the development process and in two complete systematic literature reviews afterwards. A scoring method and traffic light visualisation was developed to indicate the comprehensiveness of reporting. Results A framework for the objective and comprehensive appraisal of quality of economic evaluations in systematic literature reviews translating the guidance of CHEERS 2022 into 67 subitems with clear instructions on decision rules is provided. A traffic-light visualisation indicates degree of fulfillment at article and item level. A summary score in percentage of complete fulfillment of all criteria can be calculated at article-level. Discussion and conclusion The framework has been applied in two systematic literature reviews, including reviews on dementia and frailty. The scoring and visualisation method facilitates comparisons across reviews and identifies quality gaps across articles. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://hrbopenresearch.org/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://hrbopenresearch.org/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://hrbopenresearch.org/articles/9-16", "name": "Development of an objective assessment tool for appraising reporting..." } } ] } Home Browse Development of an objective assessment tool for appraising reporting... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Zenker AM, Thi Hoang M, Saha S and Trepel D. Development of an objective assessment tool for appraising reporting quality of economic evaluations with the Consolidated Health Economic Evaluations Reporting Standards 2022: The CHEERS framework [version 1; peer review: awaiting peer review] . HRB Open Res 2026, 9 :16 ( https://doi.org/10.12688/hrbopenres.14325.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Method Article Development of an objective assessment tool for appraising reporting quality of economic evaluations with the Consolidated Health Economic Evaluations Reporting Standards 2022: The CHEERS framework [version 1; peer review: awaiting peer review] Alina Mona Zenker https://orcid.org/0009-0007-8392-3028 1,2 , Men Thi Hoang https://orcid.org/0000-0001-8187-8277 1,3,4 , Sanjib Saha https://orcid.org/0000-0001-8649-0773 2 , Dominic Trepel https://orcid.org/0000-0002-1421-2966 1,3,5 Alina Mona Zenker https://orcid.org/0009-0007-8392-3028 1,2 , Men Thi Hoang https://orcid.org/0000-0001-8187-8277 1,3,4 , Sanjib Saha https://orcid.org/0000-0001-8649-0773 2 , Dominic Trepel https://orcid.org/0000-0002-1421-2966 1,3,5 PUBLISHED 16 Feb 2026 Author details Author details 1 Trinity College Dublin School of Medicine, Dublin, Leinster, Ireland 2 Health Economics Unit, Lund University Department of Clinical Science, Lund, Scania, Sweden 3 Trinity College Dublin, Trinity College Institute of Neuroscience, Dublin, Leinster, Ireland 4 Faculty of Business Administration, Van Lang University, Ho Chi Minh City, Vietnam 5 Global Brain Health Institute, County Dublin, County Dublin, Ireland Alina Mona Zenker Roles: Conceptualization, Data Curation, Methodology, Project Administration, Visualization, Writing – Original Draft Preparation Men Thi Hoang Roles: Conceptualization, Methodology, Writing – Review & Editing Sanjib Saha Roles: Conceptualization, Writing – Review & Editing Dominic Trepel Roles: Conceptualization, Project Administration, Writing – Review & Editing OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW Abstract Background and Aim The updated Consolidated Health Economics Evaluation Reporting Standards, CHEERS 2022, is considered the most comprehensive publication to assess reporting quality of economic evaluations (EEs) incorporating criteria of trial- and model-based studies, including emerging methods. However, it holds multiple criteria per item without clear decision rules on minimum requirements for complete reporting, which introduces subjectivity. The purpose of this study is to present the CHEERS framework, based on CHEERS 2022, a tool which enables an objective yet comprehensive quality appraisal of EEs. Method The framework was developed by translating the CHEERS 2022 explanations into decision rules, adding Boolean operators to separate multiple criteria as well as highlight decision options. Some decision rules were supported by defining “minimal” and “comprehensive” requirements. Piloting occurred during the development process and in two complete systematic literature reviews afterwards. A scoring method and traffic light visualisation was developed to indicate the comprehensiveness of reporting. Results A framework for the objective and comprehensive appraisal of quality of economic evaluations in systematic literature reviews translating the guidance of CHEERS 2022 into 67 subitems with clear instructions on decision rules is provided. A traffic-light visualisation indicates degree of fulfillment at article and item level. A summary score in percentage of complete fulfillment of all criteria can be calculated at article-level. Discussion and conclusion The framework has been applied in two systematic literature reviews, including reviews on dementia and frailty. The scoring and visualisation method facilitates comparisons across reviews and identifies quality gaps across articles. READ ALL READ LESS Keywords CHEERS, economic evaluation, quality appraisal, systematic review, reporting quality Corresponding Author(s) Dominic Trepel ( [email protected] ) Close Corresponding author: Dominic Trepel Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2026 Zenker AM et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Zenker AM, Thi Hoang M, Saha S and Trepel D. Development of an objective assessment tool for appraising reporting quality of economic evaluations with the Consolidated Health Economic Evaluations Reporting Standards 2022: The CHEERS framework [version 1; peer review: awaiting peer review] . HRB Open Res 2026, 9 :16 ( https://doi.org/10.12688/hrbopenres.14325.1 ) First published: 16 Feb 2026, 9 :16 ( https://doi.org/10.12688/hrbopenres.14325.1 ) Latest published: 16 Feb 2026, 9 :16 ( https://doi.org/10.12688/hrbopenres.14325.1 ) Introduction In 2022, a new updated guideline for reporting health economic evaluations (EEs) - the Consolidated Health Economics Evaluation Reporting Standards (CHEERS) - was published and endorsed by multiple journals 1 – 16 , including a separate publication with additional explanations and elaborations 17 . As part of the EQUATOR Network reporting guidelines, CHEERS sets out to increase transparency and quality of EEs. EEs assess a minimum of two comparators regarding their effects and costs to support decision-makers in allocating scarce resources 18 . Appraising their quality is considered an essential step when conducting a systematic literature review 19 . As an extension of CHEERS 2013 20 , the CHEERS 2022 checklist has become the new standard when appraising quality due to a more comprehensive approach. In contrast to many preceding checklists 20 – 23 , it includes both trial- and model-based studies, as well as emerging methods such as a health economic analysis plan (HEAP) and distributional cost-effectiveness analysis (DCEA) and puts an emphasis on stakeholder engagement 24 . Repeatedly reported problems inherent in this and previous checklists are no clear definition of quality, lack of comprehensiveness, difficulty in use and inherent subjectivity in the assessment process 25 , 26 . The recently published CHEQUE (Criteria for Health Economic Quality Evaluation) 27 also has been criticised for its omission of critical items as well as resource intensive application 28 . While CHEERS 2022 can be deemed comprehensive and clearly defines quality in its publications 1 – 17 , the difficulty of use and inherent subjectivity in the assessment process are still present. Item 3 of the CHEERS 2022 checklist, for example, asks the researchers to “give the context for the study, the study question, and its practical relevance for decision making in policy and practice” (1, p.5). This raises the question, at which point would this item be fulfilled in terms of reporting quality? Only if all requirements are present or already if a minimum was reported on? Furthermore, if only partial fulfillment is present, how would it be possible to analyse which elements are reported on or missing across multiple studies? These questions reappear when looking at several of the 28 items in the CHEERS checklist. Without clear instructions for the quality appraisal process the researchers must decide on the above-mentioned questions subjectively based on their professional expertise. Currently there is no objective, comprehensive quality appraisal tool to assess EEs in systematic literature reviews and its development is warranted. The purpose of this study is to present the CHEERS framework based on CHEERS 2022, which can be used to assess reporting quality in EEs. The framework is intended to eliminate subjectivity and simplify the application of CHEERS 2022 for quality assessment while not diminishing its comprehensive scope. Additionally, a scoring method is presented which is intended to increase comparability across studies and systematic literature reviews. Methods After identifying the need for an objective, comprehensive quality appraisal tool, a core team of researchers developed a first draft. During this process 14 online meetings were conducted by the first author and all co-authors from 21.11.2022 to 27.03.2023, each with an average duration of one hour. Meeting notes were taken and distributed afterwards. Notes mainly contained consensus regarding items and changes to previous agreements. Furthermore, outlines of the discussions on limitations of the pre-existing explanations, which led to the identification of a need for further specification, were documented. In the course of the meetings each item of the CHEERS 2022 checklist was discussed regarding the scope of information required to fulfill its reporting. After identifying that many items had more than one requested fulfillment, the elaboration and explanations provided by Husereau et al . 17 were translated into instructions by using the Boolean operators “AND” and “OR” to indicate decision rules. The item “3 – Introduction” of the CHEERS checklist 1 – 16 , for example, changed to “Give the context for the study AND the study question AND its practical relevance for (decision making in policy OR practice)”. After the first consensus on all items, 5 studies 29 – 33 were chosen to be piloted by the core group of four researchers. The process was conducted in Covidence (Covidence systematic review software, Veritas Health Innovation, Melbourne, Australia. Available at www.covidence.org ). A review template was created and the selected studies 29 – 33 were imported. The CHEERS framework was set up manually in Covidence, enabling two reviewers to independently and blindly assess reporting quality of included articles. Especially in items containing multiple “AND” decisions, the reviewers experienced difficulties deciding if all or only some requirements had to be fulfilled introducing subjectivity into the decision process. Following that, the items were split into sub-items with every new “AND” in the item instruction to simplify the decision when multiple requirements were listed, as well as to later be able to visualise in data which sub-items were fulfilled or not. Item 3 of the CHEERS 2022 checklist (1–16), for example, consisted of 3 sub-items (see above). In total, this resulted in 69 subitems instead of 28 items. This version was piloted again in Covidence by the four researchers using one trial-based 30 and one model-based 33 EE. Changes were discussed based on applicability, comprehensiveness, and relevance of the decision rule. These were resolved and the template updated to the new version. Instructions, such as “(Choose "not applicable" if all cost items were collected in the same year as the price year reported)” in the sub-item 15c, were added to make all answer options comprehensible. Following, two additional researchers piloted a trial-based 34 and a model-based 35 EE in parallel to two researchers of the core team. This was again set up in Covidence as described above. The quality assessments were downloaded to Microsoft® Excel® (Version 2503 Build 16.0.18623.20178) to compare the assessment results. The feedback was received in an online meeting with both the external researchers and the core team. The external researchers having used the framework for the first time described difficulties, especially in identifying minimum requirements in several items. Also, the subitems of item 5 did not give clear enough instructions. Thus, further meetings and discussions led to revising item 5 based on the descriptions by Husereau et al . 17 and defining minimum and comprehensive fulfillment criteria for subitems 5b, 6b, 7b, 7d, 7e, 13a, 14a-c, 22b and 23a. Item 28b which asked if authors used the template of the International Committee of Medical Journal Editors (ICMJE) to address their conflicts of interest (COI) was omitted. It was decided that the fact that someone used other means to make the COI transparent did not reduce the quality. This revision resulted in 67 subitems of the original 28 items. Additionally, to not deter from the originally published CHEERS 2022 checklist, as the aim was not to present a new guideline but a guideline application framework, the phrasing was edited to be as close to the original wording of the CHEERS 2022 explanation and elaboration publication 17 as possible. The resulting framework is presented in Table 1 which is available in the online repository 36 . The CHEERS framework was then piloted in two theses 37 , 38 and systematic literature reviews 39 , 40 . During the piloting and review process options to develop a scoring method aligning with the framework were briefly discussed. An adaptable scoring method and traffic-light visualisation method was developed by Hoang et al . 39 and coded in Stata (Version 18, StataCorp, 2023) ( Supplement 1 ) while applying the framework in a systematic literature review 38 . The resulting scoring and visualisation method is outlined in Results “ Suggested scoring method and traffic light visualisation” . A script was also designed for R ( Supplement 2 ), as well as a template for Excel ( Supplement 3 ). All Supplements can be accessed via the online repository 36 . Results Scope of the quality assessment tool The suggested framework ( Table 1 36 ) is intended to assess reporting quality of economic evaluations as defined by Drummond 18 . The quality is defined by grade of fulfilling criteria as proposed in the CHEERS 2022 checklist 1 – 16 and its complementary publication with further explanations and elaborations 17 . The framework incorporates direct citations from both the CHEERS 2022 checklist and the explanation and elaboration paper. The intention is for the framework to serve as an extension to both. We have adopted a checklist format and proposed a scoring method that shows the percentage of overall criteria fulfilment and allows visualisation via a traffic-light system. General application guidance of the framework Several general rules to apply the framework were agreed upon to ensure a feasible and comprehensive assessment of reporting quality of EEs. First, as described above, it should only be applied together with the original CHEERS 2022 publications 1 – 17 . Second, decisions should be supported by highlighting or referring to the specific text passage in case a third reviewer needs to comprehend the decision in a consensus. Third, all reporting given to fulfill the criteria must be in the publication or appendix. Due to resource constraints during systematic reviews, it cannot be expected to additionally read all references the publication refers to. Fourth, reporting of information should happen in the same section the item is referring to, e.g. the information on the perspective should be given in the Methods chapter. To increase transparency, decisions on the application of the tool should be stated Suggested scoring method and traffic light visualisation The scoring method was developed by Hoang et al . 39 and a coding example was developed in Stata (Version 18, StataCorp, 2023). The scoring result is expressed via a traffic light system for all 28 main items of the CHEERS 2022 1 – 16 depending on the level of comprehensive reporting of all associated subitems. Accordingly, items can be considered completely fulfilled (green light), somewhat fulfilled (orange), completely lacking (red), or “not applicable” (black). First, each subitem is graded based on the assessment made by the researchers in the framework. As shown above in the framework, there are several different assessment options including “Yes/No”, “Comprehensive/Minimal/No” as well as “Not applicable”. “Yes/No” was translated into a “1/0” grading and “Comprehensive/Minimal/No” into a “1/0,5/0” grading. Subitems deemed as “Not applicable” were labeled “99”. The total score of an item was calculated by summarising all scores of its subitems and dividing it by the number of subitems. I t e m s c o r e = S u m o f a l l s u b i t e m s c o r e s o f i t e m i N u m b e r o f a l l s u b i t e m s o f i t e m i Scoring items which contained “Not applicable” as an assessment option was slightly different. The summary score of all subitems was calculated excluding the subitems items assessed “Not applicable” and in turn the summary score was also divided by the amount of subitems which were not assessed “Not applicable”. I t e m s c o r e = S u m o f a l l a p p l i c a b l e s u b i t e m s c o r e s o f i t e m i N u m b e r o f a l l a p p l i c a b l e s u b i t e m s o f i t e m i When visualising the results, items resulting in a score of “1” were depicted in green, items resulting in a score below “1” and above “0” were depicted in orange, items resulting in a score of “0” were depicted in red. Items resulting in a score of “99” were depicted as black. A framework summary score for each article was calculated by summing all subitem scores unless they were deemed “not applicable” and dividing the sum by the number of included subitems again excluding items assessed “not applicable”: F r a m e w o r k s c o r e = S u m o f a l l a p p l i c a b l e s u b i t e m s c o r e s N u m b e r o f a l l a p p l i c a b l e s u b i t e m s In order to calculate the level of reporting of one item in all included EEs of the systematic review the following equation was applied: O v e r a l l i t e m s c o r e = S u m o f a p p l i c a b l e i t e m s c o r e s o f i t e m i ( o f e a c h a r t i c l e ) N u m b e r o f a p p l i c a b l e i t e m s c o r e s o f i t e m i A script written in Stata and R can be found in Supplements 2 and 3 36 . This is easy to apply if the quality assessment was conducted in Covidence. Otherwise, the Excel template ( Supplement 4 36 ) is more suitable to use. Discussion Summary of results The iterative piloting process led to a framework with 67 subitems with the intention to guide researchers while applying the CHEERS 2022 1 – 16 as a checklist to assess reporting quality of EEs included in systematic literature reviews. Subitems continue to have a guidance which in its words is close to or exactly like the wording of the ISPOR explanation and elaboration publication regarding CHEERS 2022 17 . Thus, this framework does not provide a de novo checklist but a method to utilise the CHEERS 2022 statement 1 – 16 . In addition to the classic binary assessment of fulfilling an item this framework introduced the variation of “minimal” and “comprehensive” reporting. Furthermore, the suggestion of a method to calculate the percentage of fulfillment of all quality requirements defined in the checklist gives researchers the opportunity to quantitatively compare the reporting quality of each item within an article and across all included articles. A traffic-light design was chosen as an adequate and easy-to-grasp visualization of the scoring. The application of the framework so far includes a review on pre-diagnosis interventions for people with dementia 39 and on geriatric assessment with a focus on frailty 40 . Therefore, transferability to other topics than the original piloting review has been demonstrated. Mending shortcomings of prior quality assessment tools Reoccurring reported shortcomings in prior quality assessment tools for EEs have been lack of comprehensiveness, difficulty in use and inherent subjectivity in the assessment process 25 , 26 . The largest strength of this study is that it is an extension of the existing CHEERS 2022 1 – 16 . CHEERS 2022 is a guidance on reporting developed by multiple experts in the field of health economics and health outcomes research, and specifically EEs. Thus, this framework is based on extensive and well reflected suggested standards for all types of economic EEs. By producing a complementary framework to the most recent published guidance, comprehensiveness was assured. Several items of the CHEERS 2022 statement are not fulfilled by one singular fact, such as choice of discount rate, but leave room for the researchers to decide when the item has been reported complete enough. Subjectivity in the assessment of each item was minimised by first translating the guidance to “OR” or “AND” options, and in a second step splitting items which had more than one condition, marked by the Boolean operator “AND”. Providing clear decision rules leaves little to no room for interpretation of assessments and the fulfillment of multiple criteria per item can be distinguished and analysed. The format of a checklist with clear guidance is intended to make the process more applicable for any level of experience. Addressing the shortcomings mentioned by Watt and Li 25 , particularly lack of comprehensiveness, difficulty in use and inherent subjectivity in the assessment process, leaves this suggested framework to be less concise than prior checklists such as BMJs 21 , CHEC 22 or Phillips 23 . Nonetheless, a comprehensive, subjective and easy to apply grading of quality in systematic reviews is essential. Furthermore, the preference of the research community to apply CHEERS checklists has been demonstrated, as CHEERS 2013 was the most applied checklist for quality appraisal of EEs only a few years after its publication 25 . This framework mends preexisting shortcomings of other checklists and satisfies the expectation of the research community. Scoring quality Few published quality appraisal checklists for EEs include a scoring method 26 . The QHES has been identified as the only published checklist with a score that is weighted by importance of the assessed items for the cost-effectiveness measure 41 . Though, limitations on the assessment of methodological quality with QHES have been discussed 26 . The CHEQUE also developed a scoring method weighted by item relevance which lets researchers estimate a relative score and rank studies of a systematic review 27 . An application study of CHEQUE criticized the method due to too much flexibility in options as well as no clear guideline on how to interpret results and suggested an alternative scoring 28 . 57,7% of systematic literature reviews of EEs conducted between 2000 and 2018 have calculated scores, partially without a scoring method present in the original publication of the applied quality assessment tools. Additionally, the presentation and structuring of scoring results varied, preventing a possible comparison across reviews. Arbitrary thresholds for high quality ranged between 63% and 94% 25 . This framework presents a possibility to visualise item scoring across included articles via a traffic light system and calculates overall fulfillment of the CHEERS checklist on a subitem level. No weighting was applied as to our knowledge only singular studies are present on to which extent each subitem or item affects the cost-effectiveness measures 42 . Nevertheless, the framework contains rich data on reporting shortcomings for each item via its subitem assessments. An additional analysis of fulfillment of the subitems can be helpful to identify common gaps or trends in reporting. Limitations Some limitations remain to be mentioned. First, the application of the framework per article is time-intensive. It is, therefore, important to emphasize documenting citations or text passages when assessing the subitems to ensure a timely consensus decision. To further consolidate the framework while not diminishing its comprehensiveness a Delphi panel of experts could establish key reporting items. Second, the framework is only as good as its template. Despite CHEERS 2022 being the considered gold standard when conducting EEs, some questions remain unanswered. Item 13, for example, refers to the valuation of outcomes but focuses mainly on preference-based outcomes whereas this would not refer to cost-effectiveness or cost-benefit analyses. More specifications or variations in examples would further improve the guidance for researchers conducting or assessing EEs. Third, the scoring method does not allow researchers to grade the quality of the appraised studies leaving the assessment to the interpretation of the researchers, readers or decision-makers. Research is warranted to assess the influence of items or subitems of the cost-effectiveness measures. Fourth, indicators such as inter-rater reliability, retest-reliability or comparisons of results across multiple checklists have not been analysed. This would further strengthen its standing compared to preexisting checklists. Fifth, additional publications on use of AI tools as well as the analysis of value of information have been published during the development of this framework but have not been included. Recommendations for future research As mentioned, this proposed checklist has not been assessed regarding its own validity or reliability which should be completed in further research. This shortcoming has also been reported regarding prior checklists 25 , 26 . Additionally, to enable the development of grading of quality of EEs studies are necessary which assess the impact of various items or subitems on the outcomes of the studies. Furthermore, a Delphi panel could identify key reporting items to make the framework more concise. Conclusion This framework presents an accessible, objective and comprehensive option to assess reporting quality of EEs alongside the CHEERS 2022 with an option to demonstrate level of fulfillment on an item and framework level. Ethical approval This study involved the development of a methodological assessment tool based exclusively on publicly available literature and reporting guidelines. It did not involve human participants, animals, or the use of identifiable personal data. Therefore, ethical approval from an institutional review board or ethics committee was not required. Data availability No datasets were used to complete this research. All extended data (Table 1, Supplement 1, Supplement 2, Supplement 3) is available at the repository “Figshare” at: https://doi.org/10.6084/m9.figshare.30978715 36 The extended data can be cited as: Zenker AZ, Hoang M, Saha S, Trépel D. 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PubMed Abstract | Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 16 Feb 2026 ADD YOUR COMMENT Comment Author details Author details 1 Trinity College Dublin School of Medicine, Dublin, Leinster, Ireland 2 Health Economics Unit, Lund University Department of Clinical Science, Lund, Scania, Sweden 3 Trinity College Dublin, Trinity College Institute of Neuroscience, Dublin, Leinster, Ireland 4 Faculty of Business Administration, Van Lang University, Ho Chi Minh City, Vietnam 5 Global Brain Health Institute, County Dublin, County Dublin, Ireland Alina Mona Zenker Roles: Conceptualization, Data Curation, Methodology, Project Administration, Visualization, Writing – Original Draft Preparation Men Thi Hoang Roles: Conceptualization, Methodology, Writing – Review & Editing Sanjib Saha Roles: Conceptualization, Writing – Review & Editing Dominic Trepel Roles: Conceptualization, Project Administration, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 16 Feb 2026, 9:16 https://doi.org/10.12688/hrbopenres.14325.1 Copyright © 2026 Zenker AM et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics VIEWS $counts.viewCount downloads Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Zenker AM, Thi Hoang M, Saha S and Trepel D. Development of an objective assessment tool for appraising reporting quality of economic evaluations with the Consolidated Health Economic Evaluations Reporting Standards 2022: The CHEERS framework [version 1; peer review: awaiting peer review] . HRB Open Res 2026, 9 :16 ( https://doi.org/10.12688/hrbopenres.14325.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: AWAITING PEER REVIEW AWAITING PEER REVIEW ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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