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How to Structure the Table of Contents for a Research Paper

4-minute read

• 16th July 2023

So you’ve made it to the important step of writing the table of contents for your paper. Congratulations on making it this far! Whether you’re writing a research paper or a dissertation , the table of contents not only provides the reader with guidance on where to find the sections of your paper, but it also signals that a quality piece of research is to follow. Here, we will provide detailed instructions on how to structure the table of contents for your research paper.

Steps to Create a Table of Contents

• Insert the table of contents after the title page.

Within the structure of your research paper , you should place the table of contents after the title page but before the introduction or the beginning of the content. If your research paper includes an abstract or an acknowledgements section , place the table of contents after it.

• List all the paper’s sections and subsections in chronological order.

Depending on the complexity of your paper, this list will include chapters (first-level headings), chapter sections (second-level headings), and perhaps subsections (third-level headings). If you have a chapter outline , it will come in handy during this step. You should include the bibliography and all appendices in your table of contents. If you have more than a few charts and figures (more often the case in a dissertation than in a research paper), you should add them to a separate list of charts and figures that immediately follows the table of contents. (Check out our FAQs below for additional guidance on items that should not be in your table of contents.)

• Paginate each section.

Label each section and subsection with the page number it begins on. Be sure to do a check after you’ve made your final edits to ensure that you don’t need to update the page numbers.

• Format your table of contents.

The way you format your table of contents will depend on the style guide you use for the rest of your paper. For example, there are table of contents formatting guidelines for Turabian/Chicago and MLA styles, and although the APA recommends checking with your instructor for formatting instructions (always a good rule of thumb), you can also create a table of contents for a research paper that follows APA style .

• Add hyperlinks if you like.

Depending on the word processing software you’re using, you may also be able to hyperlink the sections of your table of contents for easier navigation through your paper. (Instructions for this feature are available for both Microsoft Word and Google Docs .)

To summarize, the following steps will help you create a clear and concise table of contents to guide readers through your research paper:

1. Insert the table of contents after the title page.

2. List all the sections and subsections in chronological order.

3. Paginate each section.

4. Format the table of contents according to your style guide.

5. Add optional hyperlinks.

If you’d like help formatting and proofreading your research paper , check out some of our services. You can even submit a sample for free . Best of luck writing your research paper table of contents!

What is a table of contents?

A table of contents is a listing of each section of a document in chronological order, accompanied by the page number where the section begins. A table of contents gives the reader an overview of the contents of a document, as well as providing guidance on where to find each section.

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What should I include in my table of contents?

If your paper contains any of the following sections, they should be included in your table of contents:

●  Chapters, chapter sections, and subsections

●  Introduction

●  Conclusion

●  Appendices

●  Bibliography

Although recommendations may differ among institutions, you generally should not include the following in your table of contents:

●  Title page

●  Abstract

●  Acknowledgements

●  Forward or preface

If you have several charts, figures, or tables, consider creating a separate list for them that will immediately follow the table of contents. Also, you don’t need to include the table of contents itself in your table of contents.

Is there more than one way to format a table of contents?

Yes! In addition to following any recommendations from your instructor or institution, you should follow the stipulations of your style guide .

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Table of Contents

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The Table of Contents should follow these guidelines:

• ​All sections of the manuscript are listed in the Table of Contents except the Title Page, the Copyright Page, the Dedication Page, and the Table of Contents.
• You may list subsections within chapters
• Creative works are not exempt from the requirement to include a Table of Contents

Table of Contents Example

Here is an example of a Table of Contents page from the Template. Please note that your table of contents may be longer than one page.

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How to Create a Table of Contents for Dissertation, Thesis or Paper & Examples

Table of contents

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A dissertation table of contents is a list of the chapters and sections included in a dissertation or thesis, along with their page numbers. It helps to navigate the document easily and locate specific information. Each chapter or section should be listed with its corresponding page number. The table of contents should be formatted according to the guidelines of the specific style guide being used, such as APA or MLA.

We would guess that students usually start working on the table of contents at the last minute. It is quite apparent and makes sense, as this is the list of chapters and sections with page locations. Do you think it's easy? 

From our experience, it can be quite tricky to organize everything according to APA, Chicago, or any other academic writing style. In this blog, we will discuss how to write a table of contents for a research paper , thesis or dissertation in Microsoft Word. We will create it together to guide students through the process. 

Also, here you will find examples of table of contents created by thesis writers at StudyCrumb . Let’s go!

What Is a Table of Contents: Definition

It is obvious that the table of contents (TOC) is an essential manuscript part you can’t skip. If you are dealing with a dissertation, thesis or research paper, you need to know how to build it in accordance with academic guidance. This is a detailed roadmap for your work and outlined structure you can follow for a research presentation. 

In case you are working on an essay or report, you may not include the table of contents, as it is a short academic text. But for the research paper, thesis or dissertation, table of contents is essential and required. It is possible to say the same about any Master’s project. It should be located between the dissertation abstract and introduction chapter. In most cases, it is about 2-3 pages long. 

Our expert dissertation writing service prepared a great template that can be used for your work. Make your research formatting easy with ready solutions!

Types of Table of Contents

How to choose which table of contents will fit your research paper, thesis, dissertation, or report best? Make a decision based on your work length. Some academic writing styles, such as APA paper format or MLA style , have specific formatting for this list. 

However, we will outline the most commonly used typology:

• Single-level table of contents. At this type, we use only chapters. For instance, you will have an Introduction, Literature Review, methodology, and other chapters with page numbers. It can be used for shorter research work. For long writing forms like manuscripts, it can be too broad, and you will need to go into details.
• Subdivided table of contents. The most frequently used form to organize the contents table. It will include not only chapters but also sections — a level 2 subheading for each part. It will help to be more specific about what to expect in each part of your research work.
• Table of contents with multiple levels. This is a more divided structure, including subheadings with a level 3 for each section. Quite often, those subheadings can be rewritten or deleted during the last editing. It is essential to keep them in the right order.

Before you decide which type will work best for you, let us share with you some examples of each formatting style.

Example of Table of Contents With a Single Level

Introduction: The Misinformation Roots ………..…… 3 Literature Review .....................................….....………… 10 Research Methodology and Design ……................. 24 Results.............................................................................. 28 Discussion ....................................................................... 32

Sometimes, you will need to put an extra emphasis on subsections. Check this layout to see how your subheadings can be organized.

Example of Table of Contents Page with Subdivided Levels

Introduction: Information War ............……………….. 3       Background…………………………………….………..…… 4       Current State ……………………………………...…...…… 5       Defining Research Questions………………………. 9 Literature Review………………………...……………..……... 11       The Roots of Information Warfare ………....… 11        Information Wars …………………………….………..… 14        Cyber Wars Research ........................................ 17

If you are working on a lengthy, complex paper, this outline will suit your project most. It will help readers navigate through your document by breaking it down into smaller, more manageable sections.

Multi-Level Table of Contents Page Example

Introduction……………………………………………….......……….… 3       Emergence of Climate Change ………..……....….….. 3       Key Activist Groups in Climate Change .............. 5              Greenpeace International ………..…………......... 9              European Climate Foundation …….……………. 10              WWF ……………………………………….……….............. 11        Significant Movements ……………….………....……… 13 Literature Review ……………………………………......…………. 15

What Sections Should Be Included in a Table of Contents?

To start with, the scientific table of contents should include all chapters and its subheading. It is important to choose the formatting that will give your readers a full overview of your work from the very beginning. However, there are other chapters that you may miss constructing the 2-pager table. So, let's look at all you need to include:

• Dissertation introduction
• Literature review
• Research methodology
• Results section
• Dissertation discussion
• Conclusion of a thesis
• Reference list. Mention a number of a page where you start listing your sources.
• Appendices. For instance, if you have a data set, table or figure, include it in your research appendix .

This is how the ideal structured dissertation or research paper table of contents will look like. Remember that it still should take 2 pages. You need to choose the best formatting style to manage its length.

Tables, Figures, and Appendices in TOC

While creating a table of contents in a research paper, thesis or dissertation, you will need to include appendices in each case you have them. However, the formatting and adding tables and figures can vary based on the number and citation style. If you have more than 3 tables or figures, you may decide to have all of them at the end of your project. So, add them to the table of contents. 

Figures, graphics, and diagrams in research papers, dissertations and theses should be numbered. If you use them from another source, ensure that you make a proper citation based on the chosen style guide.

Appendix in Table of Contents Example

Appendix A. Row Data Set…………………………………… 41 Appendix B. IBR Data………………………………………….… 43 Appendix C. SPSS Data………………………………………… 44

What Shouldn't Be Included in a Table of Contents?

When creating a dissertation table of contents, students want to include everything they have in a document. However, some components should not be on this page. Here is what we are talking about:

• Thesis acknowledgement
• Paper abstract
• The content list itself

Acknowledgement and abstract should be located before the content list, so there is no need to add them. You need to present a clear structure that will help your readers to navigate through the work and quickly find any requested information.

How to Create a Table of Contents for a Research Paper or Dissertation In Word?

It may look like working with this list can take a long. But we have one proposal for our users. Instead of writing a table of contents manually, create it automatically in Microsoft Word. You do not need any specific tech knowledge to do this. Let’s go through this process step-by-step and explain how to make a table of contents for a research paper or dissertation in a few clicks.

• Open Home tab and choose the style for your table of contents (ToC next).
• Apply heading 1 to your chapters, heading 2 to the subheading, and if needed heading 3 to the level 3 heading.
• Next, you are going to create a research paper or PhD dissertation table of contents. Open References and choose ToC.
• Choose the citation style for your work. For example, let’s choose APL for now. Meeting all style requirements (bold font, title formatting, numbers) is essential.
• Define the number of levels for your dissertation or thesis table of contents. In case you want to have 3 levels, choose Automatic Table 2.
• You are done! Click ok, and here is your page with listed chapters!

You see how easy it can be! Every time you make changes to your text or headings, it will be automatic.

Updating Your Table of Contents in MS Word

Table of contents of a research paper or dissertation is created, and you continue to edit your work until submission. It is common practice, and with MS Word, you can automate all the updates. 

Let’s outline this process in our step-by-step guide!

• Right-click on your ToC in a document.
• Update field section is next.
• Choose “update ToC."
• Here, you can update your entire ToC — choose an option that works the best for you!

As you may see, working with automated solutions is much easier when you write a dissertation which has manifold subsections. That is why it is better to learn how to work on MS Word with the content list meaning be able to manage it effectively.

Table of Contents Examples

From our experience, students used to think that the content list was quite a complicated part of the work. Even with automated solutions, you must be clear about what to include and how to organize formatting. To solve the problem and answer all your questions, use our research paper or dissertation contents page example. Our paper writers designed a sample table of contents to illustrate the best practices and various styles in formatting the work. 

Check our samples to find advanced options for organizing your own list.

Example of Table of Contents in Research Paper

As you can see, this contents page includes sections with different levels.

Thesis/Dissertation Table of Contents Example

Have a question about your specific case? Check samples first, as we are sure you can get almost all the answers in our guides and sample sets. 

>> Read more: APA Format Table of Contents

Tips on Creating a Table of Contents

To finalize all that we shared on creating the table of contents page, let’s go through our tips list. We outline the best advice to help you with a dissertation table of contents.

• Use automated solutions for creating a list of chapters for your report, research papers, or dissertations — it will save you time in the future.
• Be clear with the formatting style you use for the research.
• Choose the best level type of list based on the paper length.
• Update a list after making changes to the text.
• Check the page list before submitting the work.

Bottom Line on Making Table of Contents for Dissertations/ Papers

To summarize, working with a research paper, thesis or dissertation table of contents can be challenging. This article outlines how to create a table of contents in Word and how to update it appropriately. You can learn what to include in the content list, how long it can be, and where to locate it. Write your work using more than one table of contents sample we prepared for students. It is often easy to check how the same list was made for other dissertations before finalizing yours. We encourage you to learn how to create a list with pages automatically and update it. It will definitely make your academic life easier.

Not sure if your work 's quality level is enough for getting a top-notch result? We’ve got you covered! Our team of skilled academic writers is always ready to help once you ask “ write my dissertation for me !" Just select your writer, send them your requirements and get a custom study tailored to your instructions.

Joe Eckel is an expert on Dissertations writing. He makes sure that each student gets precious insights on composing A-grade academic writing.

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How do I format a table of contents in MLA style?

Note: This post relates to content in the eighth edition of the MLA Handbook . For up-to-date guidance, see the ninth edition of the MLA Handbook .

Tables of contents may be formatted in a number of ways. In our publications, we sometimes list chapter numbers before chapter titles and sometimes list the chapter titles alone. We also sometimes list section heads beneath the chapter titles. After each chapter or heading title, the page number on which the chapter or section begins is provided. The following show examples from three of the MLA’s books.

From Elizabeth Brookbank and H. Faye Christenberry’s  MLA Guide to Undergraduate Research in Literature  (Modern Language Association of America, 2019):

From  Approaches to Teaching Bechdel’s  Fun Home, edited by Judith Kegan Gardiner (Modern Language Association of America, 2018):

From the  MLA Handbook , 8th ed. (Modern Language Association of America, 2016):

Need more information? Read about where to place a table of contents in your paper .

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How to Use Tables and Figures effectively in Research Papers

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Table of Contents

Data is the most important component of any research. It needs to be presented effectively in a paper to ensure that readers understand the key message in the paper. Figures and tables act as concise tools for clear presentation . Tables display information arranged in rows and columns in a grid-like format, while figures convey information visually, and take the form of a graph, diagram, chart, or image. Be it to compare the rise and fall of GDPs among countries over the years or to understand how COVID-19 has impacted incomes all over the world, tables and figures are imperative to convey vital findings accurately.

So, what are some of the best practices to follow when creating meaningful and attractive tables and figures? Here are some tips on how best to present tables and figures in a research paper.

Guidelines for including tables and figures meaningfully in a paper:

• Self-explanatory display items: Sometimes, readers, reviewers and journal editors directly go to the tables and figures before reading the entire text. So, the tables need to be well organized and self-explanatory.
• Avoidance of repetition: Tables and figures add clarity to the research. They complement the research text and draw attention to key points. They can be used to highlight the main points of the paper, but values should not be repeated as it defeats the very purpose of these elements.
• Consistency: There should be consistency in the values and figures in the tables and figures and the main text of the research paper.
• Informative titles: Titles should be concise and describe the purpose and content of the table. It should draw the reader’s attention towards the key findings of the research. Column heads, axis labels, figure labels, etc., should also be appropriately labelled.
• Adherence to journal guidelines: It is important to follow the instructions given in the target journal regarding the preparation and presentation of figures and tables, style of numbering, titles, image resolution, file formats, etc.

Now that we know how to go about including tables and figures in the manuscript, let’s take a look at what makes tables and figures stand out and create impact.

How to present data in a table?

For effective and concise presentation of data in a table, make sure to:

• Combine repetitive tables: If the tables have similar content, they should be organized into one.
• Divide the data: If there are large amounts of information, the data should be divided into categories for more clarity and better presentation. It is necessary to clearly demarcate the categories into well-structured columns and sub-columns.
• Keep only relevant data: The tables should not look cluttered. Ensure enough spacing.

Example of table presentation in a research paper

For comprehensible and engaging presentation of figures:

• Ensure clarity: All the parts of the figure should be clear. Ensure the use of a standard font, legible labels, and sharp images.
• Use appropriate legends: They make figures effective and draw attention towards the key message.
• Make it precise: There should be correct use of scale bars in images and maps, appropriate units wherever required, and adequate labels and legends.

It is important to get tables and figures correct and precise for your research paper to convey your findings accurately and clearly. If you are confused about how to suitably present your data through tables and figures, do not worry. Elsevier Author Services are well-equipped to guide you through every step to ensure that your manuscript is of top-notch quality.

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How To Write a Table of Contents for Academic Papers

Posted by Rene Tetzner | Mar 17, 2021 | How To Get Published | 0 |

How To Write a Table of Contents for Academic Papers Although every author begins a writing project with the best of intentions and an ideal outline in mind, it often proves difficult to stick to one’s initial plans as the text begins to unfold and its complexities grow in number and depth. Sometimes a document quickly exceeds the word limits for a project, and at others certain important aspects are neglected or turn out a good deal shorter than intended. Drafting a working table of contents for your writing project can provide an excellent tool for keeping your discussion on track and your text within length requirements as you write.

A working table of contents should begin with a title. This title may change as you draft your text, but a working title will help you focus your thoughts as you devise the headings and plan the content for the main parts, chapters, sections and subsections that should be added beneath it. All headings, whether numbered or not, should be formatted in effective and consistent ways that distinguish section levels and clearly indicate the overall structure of the text. These headings can also be altered as your writing advances, but they will provide an effective outline of what you need to discuss and the order in which you think the main topics should be presented. At this initial stage, it is also a good idea to write under each heading a brief summary of or rough notes about what you hope to include in that part of the document, and you can continue to add, adjust and move material around within and among the sections as your table of contents and ultimately your text progresses. Reminders of how long (measured in words, paragraphs or pages) the entire text and each of its parts should ideally be may also prove helpful.

Once you have your annotated table of contents drafted, it will serve as an informative list of both content and order that can be productively consulted as you write. Assuming you construct your working table of contents as a computer file in the same program you intend to use for writing the entire document, you can also use the table of contents as a template for composing the text as a whole, replacing your rough notes under each heading with the formal text as you draft it. This practice lends an immediate physical presence to the guidance provided by your table of contents because you are literally working within that outline, which can be especially wise if you tend to run on or become distracted by new ideas as you write.

Finally, your working table of contents can become your final table of contents if one is required for your project. If you would like to use the working table of contents in this way and are also using it as a template, be sure to rename the file and save a separate copy before you begin adding the formal text of your document. Then you can simply delete your summaries and rough notes from the original table of contents to make your final one, leaving only the headings, to which you can add relevant page numbers as required.

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How to Effectively Create a Table of Contents for Your Research Paper?

Creating a table of contents (TOC) for a research paper might seem straightforward, but it’s a crucial part of your document that requires careful consideration. A well-organized TOC not only guides your readers through your paper but also reflects the depth and thoroughness of your research. So, how do you craft a TOC that enhances the readability and professionalism of your research paper?

Understanding the Basics of a Table of Contents

Before diving into the specifics, let’s understand what a TOC is. Essentially, it’s an organized listing of the chapters and major sections of your document. It’s like a roadmap, allowing readers to quickly navigate to sections that are most relevant to them. A clear, concise, and well-formatted TOC is more than just a list; it’s an integral part of your paper’s structure.

Step-by-Step Guide to Crafting Your TOC

• Identify the Key Sections : Start by listing down all the chapters, sections, and significant sub-sections of your paper. This includes your introduction, literature review, methodology, results, discussion, and conclusion.
• Use Consistent Formatting : Consistency is key in a TOC. Use the same font style and size as your main text, but you can bold or italicize the headings for emphasis. Remember, your TOC should be easy to read and navigate.
• Leverage Word Processing Tools : Most word processors, like Microsoft Word, have built-in features to create a TOC automatically. Utilize these tools to ensure accuracy and ease of updating your TOC as your paper evolves.
• Page Numbering : Each entry in your TOC should have a corresponding page number. This is crucial for guiding your readers directly to the content they’re interested in.
• Update Regularly : As your research paper develops, so should your TOC. Regular updates ensure that the TOC accurately reflects the content of your paper.

While the basics of creating a TOC are universal, different research fields and styles might have specific requirements or preferences. For instance, APA style papers have particular guidelines for TOC formatting, including how to handle different levels of headings and page numbers. Here are some insights gathered from various online sources to help you tailor your TOC to your paper’s needs:

• APA Style Specifics : If you’re writing in APA style, pay attention to how you format the different levels of headings in your TOC. The APA guidelines provide clear instructions on this, ensuring that your TOC aligns with the rest of your document’s formatting.
• The Role of a TOC in Navigation : A TOC is more than just a list; it’s a navigational tool. It should provide a clear and concise overview of your paper’s structure, allowing readers to easily locate specific sections or topics.
• Customizing Your TOC : Depending on your research paper’s complexity, you might want to customize your TOC. This could involve including or excluding certain elements, such as figures or tables, based on their relevance to your paper’s overall structure.
• Automating Page Numbers : Modern word processors can automatically update page numbers in your TOC. This feature is incredibly useful, especially when you’re making significant edits to your paper that might affect its pagination.
• Clarity and Readability : Above all, your TOC should be clear and easy to read. Avoid cluttering it with unnecessary details. Stick to the main sections and headings that provide a straightforward overview of your paper’s content.

Remember, your TOC is often one of the first elements your readers will interact with. Make it engaging and reflective of the depth of your research. Use it to showcase the organization and thoroughness of your work. A well-crafted TOC not only aids in navigation but also sets the tone for the rest of your paper. It’s an opportunity to make a strong first impression, indicating to your readers that your research is well-structured and thoughtfully presented.

To illustrate the importance of a well-structured TOC, consider the case of a complex research paper covering multiple interconnected topics. A clear TOC allows readers to easily navigate between these topics, understanding how they interrelate and contribute to the overall thesis of the paper. This not only enhances the reader’s experience but also underscores the researcher’s ability to organize complex information effectively.

Actionable Steps

For those looking to create their own TOC, here are some actionable steps:

• Review Your Document’s Structure : Before creating your TOC, ensure that your document is well-organized with clearly defined sections and headings.
• Utilize Built-in TOC Features : Use the TOC features of your word processor to automatically generate and update your TOC.
• Customize According to Style Guides : If your paper must adhere to a specific style guide (like APA), customize your TOC to meet these requirements.
• Regularly Update Your TOC : As your paper evolves, regularly update your TOC to reflect any changes in structure or page numbers.
• Keep It Simple and Clear : Your TOC should be easy to navigate. Avoid overcomplicating it with too many sub-levels or unnecessary information.

Related Questions and Answers from “Table of Contents Research Paper”

1. What is the purpose of a table of contents in a research paper?

• A table of contents in a research paper serves as a structured guide, allowing readers to easily navigate and locate specific sections or chapters. It provides an overview of the paper’s organization and helps in understanding the flow of information.

2. How detailed should a table of contents be in a research paper?

• The level of detail in a table of contents depends on the complexity of the research paper. Generally, it should include all main sections and sub-sections, but avoid being overly detailed to maintain clarity and ease of navigation.

3. Can I automatically update the table of contents in a research paper?

• Yes, most modern word processors have the capability to automatically update the table of contents. This feature is particularly useful for maintaining accuracy in page numbering and section titles as the document evolves.

A table of contents is more than just a formality; it’s a crucial component of your research paper that enhances its readability and professionalism. By following these guidelines and adapting them to your specific needs, you can create a TOC that not only serves its functional purpose but also contributes to the overall impact of your research.

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Effective Use of Tables and Figures in Research Papers

Research papers are often based on copious amounts of data that can be summarized and easily read through tables and graphs. When writing a research paper , it is important for data to be presented to the reader in a visually appealing way. The data in figures and tables, however, should not be a repetition of the data found in the text. There are many ways of presenting data in tables and figures, governed by a few simple rules. An APA research paper and MLA research paper both require tables and figures, but the rules around them are different. When writing a research paper, the importance of tables and figures cannot be underestimated. How do you know if you need a table or figure? The rule of thumb is that if you cannot present your data in one or two sentences, then you need a table .

Using Tables

Tables are easily created using programs such as Excel. Tables and figures in scientific papers are wonderful ways of presenting data. Effective data presentation in research papers requires understanding your reader and the elements that comprise a table. Tables have several elements, including the legend, column titles, and body. As with academic writing, it is also just as important to structure tables so that readers can easily understand them. Tables that are disorganized or otherwise confusing will make the reader lose interest in your work.

• Title: Tables should have a clear, descriptive title, which functions as the “topic sentence” of the table. The titles can be lengthy or short, depending on the discipline.
• Column Titles: The goal of these title headings is to simplify the table. The reader’s attention moves from the title to the column title sequentially. A good set of column titles will allow the reader to quickly grasp what the table is about.
• Table Body: This is the main area of the table where numerical or textual data is located. Construct your table so that elements read from up to down, and not across.

Related: Done organizing your research data effectively in tables? Check out this post on tips for citing tables in your manuscript now!

The placement of figures and tables should be at the center of the page. It should be properly referenced and ordered in the number that it appears in the text. In addition, tables should be set apart from the text. Text wrapping should not be used. Sometimes, tables and figures are presented after the references in selected journals.

Using Figures

Figures can take many forms, such as bar graphs, frequency histograms, scatterplots, drawings, maps, etc. When using figures in a research paper, always think of your reader. What is the easiest figure for your reader to understand? How can you present the data in the simplest and most effective way? For instance, a photograph may be the best choice if you want your reader to understand spatial relationships.

• Figure Captions: Figures should be numbered and have descriptive titles or captions. The captions should be succinct enough to understand at the first glance. Captions are placed under the figure and are left justified.
• Image: Choose an image that is simple and easily understandable. Consider the size, resolution, and the image’s overall visual attractiveness.
• Additional Information: Illustrations in manuscripts are numbered separately from tables. Include any information that the reader needs to understand your figure, such as legends.

Common Errors in Research Papers

Effective data presentation in research papers requires understanding the common errors that make data presentation ineffective. These common mistakes include using the wrong type of figure for the data. For instance, using a scatterplot instead of a bar graph for showing levels of hydration is a mistake. Another common mistake is that some authors tend to italicize the table number. Remember, only the table title should be italicized .  Another common mistake is failing to attribute the table. If the table/figure is from another source, simply put “ Note. Adapted from…” underneath the table. This should help avoid any issues with plagiarism.

Using tables and figures in research papers is essential for the paper’s readability. The reader is given a chance to understand data through visual content. When writing a research paper, these elements should be considered as part of good research writing. APA research papers, MLA research papers, and other manuscripts require visual content if the data is too complex or voluminous. The importance of tables and graphs is underscored by the main purpose of writing, and that is to be understood.

Frequently Asked Questions

"Consider the following points when creating figures for research papers: Determine purpose: Clarify the message or information to be conveyed. Choose figure type: Select the appropriate type for data representation. Prepare and organize data: Collect and arrange accurate and relevant data. Select software: Use suitable software for figure creation and editing. Design figure: Focus on clarity, labeling, and visual elements. Create the figure: Plot data or generate the figure using the chosen software. Label and annotate: Clearly identify and explain all elements in the figure. Review and revise: Verify accuracy, coherence, and alignment with the paper. Format and export: Adjust format to meet publication guidelines and export as suitable file."

"To create tables for a research paper, follow these steps: 1) Determine the purpose and information to be conveyed. 2) Plan the layout, including rows, columns, and headings. 3) Use spreadsheet software like Excel to design and format the table. 4) Input accurate data into cells, aligning it logically. 5) Include column and row headers for context. 6) Format the table for readability using consistent styles. 7) Add a descriptive title and caption to summarize and provide context. 8) Number and reference the table in the paper. 9) Review and revise for accuracy and clarity before finalizing."

"Including figures in a research paper enhances clarity and visual appeal. Follow these steps: Determine the need for figures based on data trends or to explain complex processes. Choose the right type of figure, such as graphs, charts, or images, to convey your message effectively. Create or obtain the figure, properly citing the source if needed. Number and caption each figure, providing concise and informative descriptions. Place figures logically in the paper and reference them in the text. Format and label figures clearly for better understanding. Provide detailed figure captions to aid comprehension. Cite the source for non-original figures or images. Review and revise figures for accuracy and consistency."

"Research papers use various types of tables to present data: Descriptive tables: Summarize main data characteristics, often presenting demographic information. Frequency tables: Display distribution of categorical variables, showing counts or percentages in different categories. Cross-tabulation tables: Explore relationships between categorical variables by presenting joint frequencies or percentages. Summary statistics tables: Present key statistics (mean, standard deviation, etc.) for numerical variables. Comparative tables: Compare different groups or conditions, displaying key statistics side by side. Correlation or regression tables: Display results of statistical analyses, such as coefficients and p-values. Longitudinal or time-series tables: Show data collected over multiple time points with columns for periods and rows for variables/subjects. Data matrix tables: Present raw data or matrices, common in experimental psychology or biology. Label tables clearly, include titles, and use footnotes or captions for explanations."

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Home » Research Paper – Structure, Examples and Writing Guide

Research Paper – Structure, Examples and Writing Guide

Table of Contents

Research Paper

Definition:

Research Paper is a written document that presents the author’s original research, analysis, and interpretation of a specific topic or issue.

It is typically based on Empirical Evidence, and may involve qualitative or quantitative research methods, or a combination of both. The purpose of a research paper is to contribute new knowledge or insights to a particular field of study, and to demonstrate the author’s understanding of the existing literature and theories related to the topic.

Structure of Research Paper

The structure of a research paper typically follows a standard format, consisting of several sections that convey specific information about the research study. The following is a detailed explanation of the structure of a research paper:

The title page contains the title of the paper, the name(s) of the author(s), and the affiliation(s) of the author(s). It also includes the date of submission and possibly, the name of the journal or conference where the paper is to be published.

The abstract is a brief summary of the research paper, typically ranging from 100 to 250 words. It should include the research question, the methods used, the key findings, and the implications of the results. The abstract should be written in a concise and clear manner to allow readers to quickly grasp the essence of the research.

Introduction

The introduction section of a research paper provides background information about the research problem, the research question, and the research objectives. It also outlines the significance of the research, the research gap that it aims to fill, and the approach taken to address the research question. Finally, the introduction section ends with a clear statement of the research hypothesis or research question.

Literature Review

The literature review section of a research paper provides an overview of the existing literature on the topic of study. It includes a critical analysis and synthesis of the literature, highlighting the key concepts, themes, and debates. The literature review should also demonstrate the research gap and how the current study seeks to address it.

The methods section of a research paper describes the research design, the sample selection, the data collection and analysis procedures, and the statistical methods used to analyze the data. This section should provide sufficient detail for other researchers to replicate the study.

The results section presents the findings of the research, using tables, graphs, and figures to illustrate the data. The findings should be presented in a clear and concise manner, with reference to the research question and hypothesis.

The discussion section of a research paper interprets the findings and discusses their implications for the research question, the literature review, and the field of study. It should also address the limitations of the study and suggest future research directions.

The conclusion section summarizes the main findings of the study, restates the research question and hypothesis, and provides a final reflection on the significance of the research.

The references section provides a list of all the sources cited in the paper, following a specific citation style such as APA, MLA or Chicago.

How to Write Research Paper

You can write Research Paper by the following guide:

• Choose a Topic: The first step is to select a topic that interests you and is relevant to your field of study. Brainstorm ideas and narrow down to a research question that is specific and researchable.
• Conduct a Literature Review: The literature review helps you identify the gap in the existing research and provides a basis for your research question. It also helps you to develop a theoretical framework and research hypothesis.
• Develop a Thesis Statement : The thesis statement is the main argument of your research paper. It should be clear, concise and specific to your research question.
• Plan your Research: Develop a research plan that outlines the methods, data sources, and data analysis procedures. This will help you to collect and analyze data effectively.
• Collect and Analyze Data: Collect data using various methods such as surveys, interviews, observations, or experiments. Analyze data using statistical tools or other qualitative methods.
• Organize your Paper : Organize your paper into sections such as Introduction, Literature Review, Methods, Results, Discussion, and Conclusion. Ensure that each section is coherent and follows a logical flow.
• Write your Paper : Start by writing the introduction, followed by the literature review, methods, results, discussion, and conclusion. Ensure that your writing is clear, concise, and follows the required formatting and citation styles.
• Edit and Proofread your Paper: Review your paper for grammar and spelling errors, and ensure that it is well-structured and easy to read. Ask someone else to review your paper to get feedback and suggestions for improvement.
• Cite your Sources: Ensure that you properly cite all sources used in your research paper. This is essential for giving credit to the original authors and avoiding plagiarism.

Research Paper Example

Note : The below example research paper is for illustrative purposes only and is not an actual research paper. Actual research papers may have different structures, contents, and formats depending on the field of study, research question, data collection and analysis methods, and other factors. Students should always consult with their professors or supervisors for specific guidelines and expectations for their research papers.

Research Paper Example sample for Students:

Title: The Impact of Social Media on Mental Health among Young Adults

Abstract: This study aims to investigate the impact of social media use on the mental health of young adults. A literature review was conducted to examine the existing research on the topic. A survey was then administered to 200 university students to collect data on their social media use, mental health status, and perceived impact of social media on their mental health. The results showed that social media use is positively associated with depression, anxiety, and stress. The study also found that social comparison, cyberbullying, and FOMO (Fear of Missing Out) are significant predictors of mental health problems among young adults.

Introduction: Social media has become an integral part of modern life, particularly among young adults. While social media has many benefits, including increased communication and social connectivity, it has also been associated with negative outcomes, such as addiction, cyberbullying, and mental health problems. This study aims to investigate the impact of social media use on the mental health of young adults.

Literature Review: The literature review highlights the existing research on the impact of social media use on mental health. The review shows that social media use is associated with depression, anxiety, stress, and other mental health problems. The review also identifies the factors that contribute to the negative impact of social media, including social comparison, cyberbullying, and FOMO.

Methods : A survey was administered to 200 university students to collect data on their social media use, mental health status, and perceived impact of social media on their mental health. The survey included questions on social media use, mental health status (measured using the DASS-21), and perceived impact of social media on their mental health. Data were analyzed using descriptive statistics and regression analysis.

Results : The results showed that social media use is positively associated with depression, anxiety, and stress. The study also found that social comparison, cyberbullying, and FOMO are significant predictors of mental health problems among young adults.

Discussion : The study’s findings suggest that social media use has a negative impact on the mental health of young adults. The study highlights the need for interventions that address the factors contributing to the negative impact of social media, such as social comparison, cyberbullying, and FOMO.

Conclusion : In conclusion, social media use has a significant impact on the mental health of young adults. The study’s findings underscore the need for interventions that promote healthy social media use and address the negative outcomes associated with social media use. Future research can explore the effectiveness of interventions aimed at reducing the negative impact of social media on mental health. Additionally, longitudinal studies can investigate the long-term effects of social media use on mental health.

Limitations : The study has some limitations, including the use of self-report measures and a cross-sectional design. The use of self-report measures may result in biased responses, and a cross-sectional design limits the ability to establish causality.

Implications: The study’s findings have implications for mental health professionals, educators, and policymakers. Mental health professionals can use the findings to develop interventions that address the negative impact of social media use on mental health. Educators can incorporate social media literacy into their curriculum to promote healthy social media use among young adults. Policymakers can use the findings to develop policies that protect young adults from the negative outcomes associated with social media use.

References :

• Twenge, J. M., & Campbell, W. K. (2019). Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study. Preventive medicine reports, 15, 100918.
• Primack, B. A., Shensa, A., Escobar-Viera, C. G., Barrett, E. L., Sidani, J. E., Colditz, J. B., … & James, A. E. (2017). Use of multiple social media platforms and symptoms of depression and anxiety: A nationally-representative study among US young adults. Computers in Human Behavior, 69, 1-9.
• Van der Meer, T. G., & Verhoeven, J. W. (2017). Social media and its impact on academic performance of students. Journal of Information Technology Education: Research, 16, 383-398.

Appendix : The survey used in this study is provided below.

Social Media and Mental Health Survey

• How often do you use social media per day?
• Less than 30 minutes
• 30 minutes to 1 hour
• 1 to 2 hours
• 2 to 4 hours
• More than 4 hours
• Which social media platforms do you use?
• Others (Please specify)
• How often do you experience the following on social media?
• Social comparison (comparing yourself to others)
• Cyberbullying
• Fear of Missing Out (FOMO)
• Have you ever experienced any of the following mental health problems in the past month?
• Do you think social media use has a positive or negative impact on your mental health?
• Very positive
• Somewhat positive
• Somewhat negative
• Very negative
• In your opinion, which factors contribute to the negative impact of social media on mental health?
• Social comparison
• In your opinion, what interventions could be effective in reducing the negative impact of social media on mental health?
• Education on healthy social media use
• Counseling for mental health problems caused by social media
• Social media detox programs
• Regulation of social media use

Thank you for your participation!

Applications of Research Paper

Research papers have several applications in various fields, including:

• Advancing knowledge: Research papers contribute to the advancement of knowledge by generating new insights, theories, and findings that can inform future research and practice. They help to answer important questions, clarify existing knowledge, and identify areas that require further investigation.
• Informing policy: Research papers can inform policy decisions by providing evidence-based recommendations for policymakers. They can help to identify gaps in current policies, evaluate the effectiveness of interventions, and inform the development of new policies and regulations.
• Improving practice: Research papers can improve practice by providing evidence-based guidance for professionals in various fields, including medicine, education, business, and psychology. They can inform the development of best practices, guidelines, and standards of care that can improve outcomes for individuals and organizations.
• Educating students : Research papers are often used as teaching tools in universities and colleges to educate students about research methods, data analysis, and academic writing. They help students to develop critical thinking skills, research skills, and communication skills that are essential for success in many careers.
• Fostering collaboration: Research papers can foster collaboration among researchers, practitioners, and policymakers by providing a platform for sharing knowledge and ideas. They can facilitate interdisciplinary collaborations and partnerships that can lead to innovative solutions to complex problems.

When to Write Research Paper

Research papers are typically written when a person has completed a research project or when they have conducted a study and have obtained data or findings that they want to share with the academic or professional community. Research papers are usually written in academic settings, such as universities, but they can also be written in professional settings, such as research organizations, government agencies, or private companies.

Here are some common situations where a person might need to write a research paper:

• For academic purposes: Students in universities and colleges are often required to write research papers as part of their coursework, particularly in the social sciences, natural sciences, and humanities. Writing research papers helps students to develop research skills, critical thinking skills, and academic writing skills.
• For publication: Researchers often write research papers to publish their findings in academic journals or to present their work at academic conferences. Publishing research papers is an important way to disseminate research findings to the academic community and to establish oneself as an expert in a particular field.
• To inform policy or practice : Researchers may write research papers to inform policy decisions or to improve practice in various fields. Research findings can be used to inform the development of policies, guidelines, and best practices that can improve outcomes for individuals and organizations.
• To share new insights or ideas: Researchers may write research papers to share new insights or ideas with the academic or professional community. They may present new theories, propose new research methods, or challenge existing paradigms in their field.

Purpose of Research Paper

The purpose of a research paper is to present the results of a study or investigation in a clear, concise, and structured manner. Research papers are written to communicate new knowledge, ideas, or findings to a specific audience, such as researchers, scholars, practitioners, or policymakers. The primary purposes of a research paper are:

• To contribute to the body of knowledge : Research papers aim to add new knowledge or insights to a particular field or discipline. They do this by reporting the results of empirical studies, reviewing and synthesizing existing literature, proposing new theories, or providing new perspectives on a topic.
• To inform or persuade: Research papers are written to inform or persuade the reader about a particular issue, topic, or phenomenon. They present evidence and arguments to support their claims and seek to persuade the reader of the validity of their findings or recommendations.
• To advance the field: Research papers seek to advance the field or discipline by identifying gaps in knowledge, proposing new research questions or approaches, or challenging existing assumptions or paradigms. They aim to contribute to ongoing debates and discussions within a field and to stimulate further research and inquiry.
• To demonstrate research skills: Research papers demonstrate the author’s research skills, including their ability to design and conduct a study, collect and analyze data, and interpret and communicate findings. They also demonstrate the author’s ability to critically evaluate existing literature, synthesize information from multiple sources, and write in a clear and structured manner.

Characteristics of Research Paper

Research papers have several characteristics that distinguish them from other forms of academic or professional writing. Here are some common characteristics of research papers:

• Evidence-based: Research papers are based on empirical evidence, which is collected through rigorous research methods such as experiments, surveys, observations, or interviews. They rely on objective data and facts to support their claims and conclusions.
• Structured and organized: Research papers have a clear and logical structure, with sections such as introduction, literature review, methods, results, discussion, and conclusion. They are organized in a way that helps the reader to follow the argument and understand the findings.
• Formal and objective: Research papers are written in a formal and objective tone, with an emphasis on clarity, precision, and accuracy. They avoid subjective language or personal opinions and instead rely on objective data and analysis to support their arguments.
• Citations and references: Research papers include citations and references to acknowledge the sources of information and ideas used in the paper. They use a specific citation style, such as APA, MLA, or Chicago, to ensure consistency and accuracy.
• Peer-reviewed: Research papers are often peer-reviewed, which means they are evaluated by other experts in the field before they are published. Peer-review ensures that the research is of high quality, meets ethical standards, and contributes to the advancement of knowledge in the field.
• Objective and unbiased: Research papers strive to be objective and unbiased in their presentation of the findings. They avoid personal biases or preconceptions and instead rely on the data and analysis to draw conclusions.

Advantages of Research Paper

Research papers have many advantages, both for the individual researcher and for the broader academic and professional community. Here are some advantages of research papers:

• Contribution to knowledge: Research papers contribute to the body of knowledge in a particular field or discipline. They add new information, insights, and perspectives to existing literature and help advance the understanding of a particular phenomenon or issue.
• Opportunity for intellectual growth: Research papers provide an opportunity for intellectual growth for the researcher. They require critical thinking, problem-solving, and creativity, which can help develop the researcher’s skills and knowledge.
• Career advancement: Research papers can help advance the researcher’s career by demonstrating their expertise and contributions to the field. They can also lead to new research opportunities, collaborations, and funding.
• Academic recognition: Research papers can lead to academic recognition in the form of awards, grants, or invitations to speak at conferences or events. They can also contribute to the researcher’s reputation and standing in the field.
• Impact on policy and practice: Research papers can have a significant impact on policy and practice. They can inform policy decisions, guide practice, and lead to changes in laws, regulations, or procedures.
• Advancement of society: Research papers can contribute to the advancement of society by addressing important issues, identifying solutions to problems, and promoting social justice and equality.

Limitations of Research Paper

Research papers also have some limitations that should be considered when interpreting their findings or implications. Here are some common limitations of research papers:

• Limited generalizability: Research findings may not be generalizable to other populations, settings, or contexts. Studies often use specific samples or conditions that may not reflect the broader population or real-world situations.
• Potential for bias : Research papers may be biased due to factors such as sample selection, measurement errors, or researcher biases. It is important to evaluate the quality of the research design and methods used to ensure that the findings are valid and reliable.
• Ethical concerns: Research papers may raise ethical concerns, such as the use of vulnerable populations or invasive procedures. Researchers must adhere to ethical guidelines and obtain informed consent from participants to ensure that the research is conducted in a responsible and respectful manner.
• Limitations of methodology: Research papers may be limited by the methodology used to collect and analyze data. For example, certain research methods may not capture the complexity or nuance of a particular phenomenon, or may not be appropriate for certain research questions.
• Publication bias: Research papers may be subject to publication bias, where positive or significant findings are more likely to be published than negative or non-significant findings. This can skew the overall findings of a particular area of research.
• Time and resource constraints: Research papers may be limited by time and resource constraints, which can affect the quality and scope of the research. Researchers may not have access to certain data or resources, or may be unable to conduct long-term studies due to practical limitations.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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How to Create Table of Contents for Research Paper?

The table of contents is one of the most crucial components to include while writing a research paper, master’s thesis, or PhD dissertation.

Because it gives examiners a thorough and comprehensive list that they may use as a road map to go through each respective chapter, containing all relevant sections and subsections of material.

In this article, we will learn how to create table of contents for research paper? and learn what to include in table of contents with the help of examples and guide you how to create table of contents using Microsoft Word.

• Table of Contents

What is Table of Contents?

A table of contents is a systematic list of the headings and subheadings within a research paper, along with their corresponding page numbers.

The chapters and significant sections of your thesis, dissertation, or research paper should be listed in the table of contents together with their corresponding page numbers. A clear, well-formatted table of contents is important because it shows the reader that a quality paper will follow.

The table of contents should be placed between the abstract and the introduction. The maximum length should be two pages. There are several formatting alternatives available depending on the type of your thesis, research paper or dissertation topic.

What to Include in Your Table of Contents?

• Main Headings: Include the main sections or chapters of your research paper. These headings represent the major topics you will be addressing and should be descriptive enough to give readers an idea of the content covered in each section.
• Subheadings: If your research paper is lengthy and consists of several subsections within each main heading, include subheadings in your table of contents. These subheadings provide a more detailed breakdown of the content and allow readers to locate specific information within a particular section.
• Page Numbers: List the page numbers on which each heading and subheading can be found. This ensures that readers can quickly flip to the desired page and find the relevant information.

Your academic field and thesis length will determine how your table of contents is formatted. A methodical structure is used in some areas, such as the sciences, and includes suggested subheadings for methodology, data results, discussion, and conclusion.

On the other hand, humanities subjects are far more diverse. Regardless of the discipline you are working in, you must make an organized list of every chapter in the order that they occur, properly labelling the chapter subheadings.

Example: Table of Contents

The key features of a table of contents are:

• Clear headings and subheadings
• Corresponding page numbers

Check with your educational institution to see if they have any formatting or design requirements.

Table of Contents: Sample for a Short Dissertation

In a short dissertation, the table of contents serves as a roadmap for readers, outlining the main sections and subsections of the research paper.

It typically includes an introduction that sets the context, a literature review that analyzes existing scholarly works, a methodology section that describes the research design and data collection methods, a results and findings section that presents the research outcomes, and a conclusion that summarizes the key findings and implications.

Table of Contents: Sample for a PhD Dissertation

In a PhD dissertation, the table of contents provides a comprehensive overview of the entire research work. It encompasses various sections, starting with the title page and abstract, followed by acknowledgments and a detailed table of contents.

The contents include chapters such as introduction, literature review, methodology, results and findings, conclusion, and references. Additionally, there may be lists of figures and tables, as well as appendices containing supplementary materials.

This extensive table of contents helps readers navigate through the comprehensive research study and locate specific sections of interest.

Creating a Table of Contents in Microsoft Word

Apply heading styles.

Assign appropriate heading styles (e.g., Heading 1, Heading 2, etc.) to the main headings and subheadings in your research paper. This can be done using the “Styles” feature in Microsoft Word’s “Home” tab.

Insert a Table of Contents

There may be a lot of space needed for a table of contents. A table of contents should be placed on a blank page towards the beginning of a document.

• Where you wish to insert a Table of Contents, click in the document.
• On the ribbon, click the References tab.
• Then, select Table of Contents.
• A collection of built-in styles appears. Choose one of these, look at additional tables of contents on Office.com, or design your own table of contents.
• Select a table of contents style.

The table of contents is added, listing all of the headings in the document in outline order, as well as the page number on which each heading occurs.

Update the Table of Contents

Make a note to yourself to update your table of contents as one of your final tasks before submitting your dissertation or paper. As you enter your final revisions, it’s common for your text to slightly change, but it’s critical that your page numbers still match.

In Microsoft Word, it’s simple to update your page numbers automatically. Simply choose “Update Field” from the context menu when you right-click the contents page. You have the option of updating your table of contents entirely or just the page numbers.

Other articles

Please read through some of our other articles with examples and explanations if you’d like to learn more about research methodology.

Citation Styles

• APA Reference Page
• MLA Citations
• Chicago Style Format
• “et al.” in APA, MLA, and Chicago Style
• Do All References in a Reference List Need to Be Cited in Text?

Comparision

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• Reliability vs Validity
• Population vs Sample
• Conceptual Framework and Theoretical Framework
• Bibliography and Reference
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• Ethnography
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• Secondary Data Collection
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• Ex-Post-Facto
•   Dissertation Topic
• Thesis Statement
• Research Proposal
• Research Questions
• Research Problem
• Research Gap
• Types of Research Gaps
• Operationalization of Variables
• Literature Review
• Research Hypothesis
• Questionnaire
• Reliability
• Measurement of Scale
• Sampling Techniques
• Acknowledgements
• PLS-SEM model
• Principal Components Analysis
• Multivariate Analysis
• Friedman Test
• Chi-Square Test (Χ²)
• Effect Size
• Critical Values in Statistics
• Statistical Analysis
• Calculate the Sample Size for Randomized Controlled Trials
• Covariate in Statistics
• Avoid Common Mistakes in Statistics
• Standard Deviation
• Derivatives & Formulas
• Build a PLS-SEM model using AMOS
• Principal Components Analysis using SPSS
• Statistical Tools
• One-tailed and Two-tailed Test

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9 qualitative research designs and research methods, tips to increase your journal citation score, types of research quiz, difference between cohort study and case control study, convenience sampling: method and examples, difference between cohort and panel study, why is a pilot study important in research, panel survey: definition with examples, what is panel study, what is a cohort study | definition & examples.

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Volume 627 Issue 8005, 28 March 2024

Qubit quota.

The accumulation of errors hampers the use of quantum computers. Although there are ways to design circuits so they detect and correct errors, this typically requires a substantial number of additional qubits. In this week’s issue, researchers at IBM present a protocol for low-overhead error correction in quantum computers. The researchers use low-density parity-check codes, which correct errors by monitoring several symmetries each supported on only a small set of qubits. This code performed as well as established error-correction protocols but crucially needed only about one-tenth of the qubits. This could make error-corrected quantum computers substantially smaller machines than previously assumed. The cover image offers an artistic rendering of the qubit connectivity required for the new protocol in which each qubit needs to interact with six others. Qubits are linked as if they were placed onto the surface of a torus.

Cover image: IBM

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This paper is in the following e-collection/theme issue:

Published on 29.3.2024 in Vol 26 (2024)

Usability of Health Care Price Transparency Data in the United States: Mixed Methods Study

Authors of this article:

Original Paper

• Negar Maleki 1 , PhD   ; 
• Balaji Padmanabhan 2 , PhD   ; 
• Kaushik Dutta 1 , PhD  

1 School of Information Systems and Management, Muma College of Business, University of South Florida, Tampa, FL, United States

2 Decision, Operations & Information Technologies Department, Robert H. Smith School of Business, University of Maryland, College Park, MD, United States

Corresponding Author:

Negar Maleki, PhD

School of Information Systems and Management

Muma College of Business

University of South Florida

4202 E Fowler Avenue

Tampa, FL, 33620

United States

Phone: 1 8139742011

Email: [email protected]

Background: Increasing health care expenditure in the United States has put policy makers under enormous pressure to find ways to curtail costs. Starting January 1, 2021, hospitals operating in the United States were mandated to publish transparent, accessible pricing information online about the items and services in a consumer-friendly format within comprehensive machine-readable files on their websites.

Objective: The aims of this study are to analyze the available files on hospitals’ websites, answering the question—is price transparency (PT) information as provided usable for patients or for machines?—and to provide a solution.

Methods: We analyzed 39 main hospitals in Florida that have published machine-readable files on their website, including commercial carriers. We created an Excel (Microsoft) file that included those 39 hospitals along with the 4 most popular services—Current Procedural Terminology (CPT) 45380, 29827, and 70553 and Diagnosis-Related Group (DRG) 807—for the 4 most popular commercial carriers (Health Maintenance Organization [HMO] or Preferred Provider Organization [PPO] plans)—Aetna, Florida Blue, Cigna, and UnitedHealthcare. We conducted an A/B test using 67 MTurkers (randomly selected from US residents), investigating the level of awareness about PT legislation and the usability of available files. We also suggested format standardization, such as master field names using schema integration, to make machine-readable files consistent and usable for machines.

Results: The poor usability and inconsistent formats of the current PT information yielded no evidence of its usefulness for patients or its quality for machines. This indicates that the information does not meet the requirements for being consumer-friendly or machine readable as mandated by legislation. Based on the responses to the first part of the experiment (PT awareness), it was evident that participants need to be made aware of the PT legislation. However, they believe it is important to know the service price before receiving it. Based on the responses to the second part of the experiment (human usability of PT information), the average number of correct responses was not equal between the 2 groups, that is, the treatment group (mean 1.23, SD 1.30) found more correct answers than the control group (mean 2.76, SD 0.58; t 65 =6.46; P <.001; d =1.52).

Conclusions: Consistent machine-readable files across all health systems facilitate the development of tools for estimating customer out-of-pocket costs, aligning with the PT rule’s main objective—providing patients with valuable information and reducing health care expenditures.

Introduction

From 1970 to 2020, on a per capita basis, health care expenditures in the United States have increased sharply from US $353 per person to US $12,531 per person. In constant 2020 dollars, the increase was from US $1875 in 1970 to US $12,531 in 2020 [ 1 ]. The significant rise in health care expenses has put policy makers under enormous pressure to find ways to contain these expenditures. Price transparency (PT) in health care is 1 generally proposed strategy for addressing these problems [ 2 ] and has been debated for years [ 3 ]. Some economists believe that PT in health care will cut health care prices in the same way it has in other industries, while others argue that owing to the specific characteristics of the health care market, PT would not ameliorate rising health care costs. Price elasticity also does not typically apply in health care, since, if a problem gets severe, people will typically seek treatment regardless of cost, with the drawback that individuals learn of their health care costs after receiving treatment [ 4 ]. Complex billing processes, hidden insurer-provider contracts, the sheer quantity of third-party payers, and substantial quality differences in health care delivery are other unique aspects of health care that complicate the situation considerably.

The Centers for Medicare & Medicaid Services (CMS) mandated hospitals to post negotiated rates, including payer-specific negotiated costs, for 300 “shoppable services” beginning in January 2021. The list must include 70 CMS-specified services and an additional 230 services each hospital considers relevant to its patient population. Hospitals must include each third-party payer and their payer-specific fee when negotiating multiple rates for the same care. The data must be displayed simply, easily accessible (without requiring personal information from the patient), and saved in a machine-readable manner [ 5 ]. These efforts aim to facilitate informed patient decision-making, reduce out-of-pocket spending, and decrease health care expenditures. Former Secretary of Health and Human Services, Alex Azar, expressed a vision of hospital PT when declaring the new legislation “a patient-centered system that puts you in control and provides the affordability you need, the options and control you want, and the quality you deserve. Providing patients with clear, accessible information about the price of their care is a vital piece of delivering on that vision” [ 6 ].

Despite the legislation, it is not clear if people are actually engaging in using PT tools. For example, in 2007, New Hampshire’s HealthCost website was established, providing the negotiated price and out-of-pocket costs for 42 commonly used services by asking whether the patient is insured or their insurer and the zip code to post out-of-pocket costs in descending order. Mehrotra et al [ 7 ] examined this website over 3 years to understand how often and why these tools have mainly been used. Their analysis suggested that despite the growing interest in PT, approximately 1% of the state’s population used this tool. Low PT tool usage was also seen in other studies [ 8 - 10 ], suggesting that 3% to 12% of individuals who were offered the tool used it during the study period, and in all studies, the duration was at least 12 months. Thus, offering PT tools does not in itself lead to decreased total spending, since few people who have access to them use them to browse for lower-cost services [ 7 , 11 ].

In a recent paper, researchers addressed 1 possible reason for low engagement—lack of awareness. They implemented an extensive targeted online advertising campaign using Google Advertisements to increase awareness and assessed whether it increased New Hampshire’s PT website use. Their findings suggested that although lack of awareness is a possible reason for the low impact of PT tools in health care spending, structural factors might affect the use of health care information [ 12 ]. Individuals may not be able to exactly determine their out-of-pocket expenses from the information provided.

Surprisingly, there is little research on the awareness and usability of PT information after the current PT legislation went into effect. A recent study [ 13 ] highlighted the nonusability of existing machine-readable files for employers, policy makers, researchers, or consumers, and this paper adds to this literature by answering the question—is PT information as provided usable for patients or machines? Clearly, if it is of value to patients, it can be useful; the reason to take the perspective of machines was to examine whether this information as provided might also be useful for third-party programs that can extract information from the provided data (to subsequently help patients through other ways of presenting this information perhaps). We address this question through a combination of user experiments and data schema analysis. While there are recent papers that have also argued that PT data have deficiencies [ 13 , 14 ], ours is the first to combine user experiments with analysis of data schema from several hospitals in Florida to make a combined claim on value for patients and machines. We hope this can add to the discourse on PT and what needs to be done to extract value for patients and the health care system as a whole.

Impact of PT Tools

The impact of PT tools on consumers and health care facilities has been investigated in the literature. Some studies showed that consumers with access to PT tools are more likely to reduce forgone needed services over time. Moreover, consumers who use tools tend to find the lowest service prices [ 8 , 15 - 17 ]. A few studies investigated the impact of PT tools on the selection of health care facilities. They illustrated that some consumers tend to change health care facilities pursuing lower prices, while some others prefer to stay with expensive ones, although they are aware of some other facilities that offer lower prices [ 9 , 18 ]. Finally, some research studied the impact of PT tools on cost and showed that some consumers experienced no effect, while others experienced decreases in average consumer expenses [ 8 , 17 , 18 ]. However, the impact of PT tools on health care facilities is inconclusive, meaning different studies concluded different effects. Some stated that PT tools decrease the prices of imaging and laboratory services, while others said that although public charge disclosure lowers health care facility charges, the final prices remained unchanged [ 17 , 18 ].

Legislation Related Works

In a study, researchers considered 20 leading US hospitals to assess provided chargemasters to understand to what extent patients can obtain information from websites to determine the out-of-pocket costs [ 19 ]. Their findings showed that although all hospitals provided chargemasters on their websites, they rarely offered transparent information, making it hard for patients to determine out-of-pocket costs. Their analysis used advanced diagnostic imaging services to assess hospitals’ chargemasters since these are the most common services people look for. Mehrotra et al [ 7 ] also mentioned that the most common searches belonged to outpatient visits, magnetic resonance imaging (MRI), and emergency department visits. To this end, we used “MRI scan of the brain before and after contrast” as one of the shoppable services in our analysis. Another study examined imaging services in children’s hospitals (n=89), restricting the analysis to hospitals (n=35) that met PT requirements—published chargemaster rates, discounted cash prices, and payer-negotiated prices in a machine-readable file, and published costs for 300 common shoppable medical services in a consumer-friendly format. Their study revealed that, in addition to a broad range of imaging service charges, most hospitals lack the machine-readable file requirement [ 20 ].

Arvisais-Anhalt et al [ 21 ] identified 11 hospitals with available chargemasters in Dallas County to compare the prices of a wide range of available services. They observed significant variations for a laboratory test: partial thromboplastin time, a medication: 5 mg tablet of amlodipine, and a procedure: circumcision. Reddy et al [ 22 ] focus on New York State to assess the accessibility and usability of hospitals’ chargemasters from patients’ viewpoint. They found that 189 out of 202 hospitals had a locatable chargemaster on their home page. However, only 37 hospitals contain the Current Procedural Terminology (CPT) code, which makes those without the CPT code unusable due to the existence of many different descriptions for the same procedure; for example, an elective heart procedure had 34 entries. We add to this considerable literature by examining a subset of Florida hospitals.

In a competitive market, higher-quality goods and services require higher prices [ 23 ]. Based on this, Patel et al [ 24 ] examined the relationship between the Diagnosis-Related Group (DRG) chargemaster and quality measures. Although prior research found no convincing evidence that hospitals with greater costs also delivered better care [ 25 ], they discovered 2 important quality indicators that were linked to standard charges positively and substantially—mortality rate and readmission rates—which both are quality characteristics that are in line with economic theory. Moreover, Patel et al [ 24 ] studied the variety of one of the most commonly performed services (vaginal delivery) as a DRG code, which motivated us to select “Vaginal delivery without sterilization or D&C without CC/MCC” as another shoppable service in our analysis.

Ethical Considerations

All data used in this study, including the secondary data set obtained from hospitals’ websites and the data collected during the user experiment, underwent a thorough anonymization process. The study was conducted under protocols approved by the University of South Florida institutional review board (STUDY004145: “Effect of price transparency regulation (PTR) on the public decisions”) under HRP-502b(7) Social Behavioral Survey Consent. This approval encompassed the use of publicly available anonymized secondary data from hospitals’ websites, as well as a user experiment aimed at assessing awareness of the PT rule and the usability of hospitals’ files. No individual-specific data were collected during the experiment, which solely focused on capturing subjects’ awareness and opinions regarding the PT rule and associated files. At the onset of the experiment, participants were provided with a downloadable consent form and were allowed to withdraw their participation at any time. Survey participants were offered a US $2 reward, and their involvement was entirely anonymous.

Data Collection

According to CMS, “Starting January 1, 2021, each hospital operating in the United States will be required to provide clear, accessible pricing information online about the items and services they provide in two ways: 1- As a comprehensive machine-readable file with all items and services. 2- In a display of shoppable services in a consumer-friendly format.” As stated, files available on hospitals’ websites should be consumer-friendly, so the question of whether these files are for users arises. On the other hand, as stated, files should be machine-readable, so again the question of whether these files are for machines arises. Below we try to answer both questions in detail, respectively.

Value for Users: User Experiments

When a public announcement is disseminated, its efficacy relies on ensuring widespread awareness and facilitating practical use during times of necessity. Previous research on PT announcements has highlighted the challenges faced by patients in accurately estimating out-of-pocket expenses. However, a fundamental inquiry arises—are individuals adequately informed about the availability of tools that enable them to estimate their out-of-pocket costs for desired services? To address this, we conducted a survey to assess public awareness of PT legislation. The survey encompassed a range of yes or no and multiple-choice questions aimed at gauging participants’ familiarity with the PT rule in health care and their entitlement to obtain cost information prior to receiving a service. Additionally, we inquired about participants’ knowledge of resources for accessing pricing information and whether they were aware of the PT rule. Furthermore, we incorporated follow-up questions to ensure that the survey responses were not provided arbitrarily, thereby securing reliable and meaningful outcomes.

Moreover, considering the previously established evidence of subpar usability associated with the currently available files, we propose streamlining the existing files and developing a user-friendly and comprehensive document for conducting an A/B test. This test aims to evaluate which file better facilitates participants in accurately estimating their out-of-pocket costs. In collaboration with Florida Blue experts during biweekly meetings throughout the entire process outlined in this paper, the authors determined the optimal design for the summary table. This design, which presents prices in a more user-friendly format, enhancing overall participant comprehension, was used during the A/B testing. Participants were randomly assigned to either access the hospitals’ files or a meticulously constructed summary table, manually created in Excel, prominently displaying cost information (Please note that all files, including the hospitals’ files and our Excel file, are made available in the same format [Excel] on a cloud-based platform to eliminate any disparities in accessing the files. This ensures equitable ease of finding, downloading, and opening files, as accessing the hospitals’ files typically requires significant effort.). The experiment entailed presenting 3 distinct health-related scenarios and instructing participants to locate the price for the requested service. Subsequently, participants were asked to provide the hospital name, service price, insurer name, and insurance plan. Additionally, we sought feedback on the perceived difficulty of finding the requested service and their priority for selecting hospitals [ 26 ], followed by Likert scale questions to assess participants’ evaluation of the provided file’s efficacy in facilitating price retrieval.

The experiments were conducted to investigate the following questions: (1) Are the individuals aware of the PT legislation? and (2) Is the information provided usable for patients? To evaluate the usability of files found on websites, we selected 2 prevalent services based on existing literature and 2 other services recommended as high-demand ones by Florida Blue experts, Table 1 . Furthermore, meticulous efforts were made to ensure that both the control and treatment groups encountered identical circumstances, thus allowing for a systematic examination of the disparities solely attributable to variations in data representation.

a DRG: Diagnosis-Related Group.

b D&C: dilation and curettage.

c CC/MCC: complication or comorbidity/major complication or comorbidity.

d CPT: Current Procedural Terminology.

e MRI: magnetic resonance imaging.

Participants

A total of 67 adults (30 female individuals; mean 41.43, SD 12.39 years) were recruited on the Amazon Mechanical Turk platform, with no specific selection criteria other than being located in the United States.

We focused on 75 main hospitals (ie, the main hospital refers to distinguish a hospital from smaller clinics or specialized medical centers within the same health system) in the state of Florida. When we searched their websites for PT files (machine-readable files), only 89% (67/75) of hospitals included machine-readable files. According to the PT legislation, these files were supposed to contain information about 300 shoppable services. However, only 58% (39/67) of hospitals included information such as insurer prices in their files. Therefore, for the rest of the analysis, we only included the 39 hospitals that have the required information in their machine-readable files on their websites. We created an Excel file that included those 39 hospitals along with the 4 services—CPT 45380, 29827 and 70553 and DRG 807—mentioned in the literature ( Table 1 ) for 4 popular (suggested by Florida Blue experts) commercial carriers (Health Maintenance Organization [HMO] or Preferred Provider Organization [PPO] plans)—Aetna, Florida Blue, Cigna, and UnitedHealthcare.

Participants were recruited for the pilot and randomly assigned by the Qualtrics XM platform to answer multiple-choice questions and fill in blanks based on the given scenarios. First, participants responded to questions regarding the awareness of PT and then were divided into 2 groups randomly to answer questions regarding the usability of hospital-provided PT information. One group was assigned hospitals’ website links (control group), while the other group was given an Excel file with the same information provided in files on hospitals’ websites, but in a manner that was designed to allow easier comparison of prices across hospitals ( Multimedia Appendix 1 ). Participants were given 3 scenarios that asked them to find a procedure’s price based on their hospital and insurer selection to compare hospital-provided information with Excel. We provide some examples of hospitals’ files and our Excel file in Multimedia Appendix 1 and the survey experiment questions in Multimedia Appendix 2 .

Value for Machines: Schema Integration—Machine-Readable Files Representation

Through meticulous investigation of machine-readable files from 39 hospitals, we discovered that these files may vary in formats such as CSV or JSON, posing a challenge for machines to effectively manage the data within these files. Another significant obstacle arises from the lack of uniformity in data representation across these files, rendering them unsuitable for machine use without a cohesive system capable of processing them collectively. Our analysis revealed that hospitals within a single health system exhibit consistent data representation, although service prices may differ (we include both the same and different chargemaster prices in our study), while substantial disparities in data representation exist between hospitals affiliated with different health systems.

Moving forward, we will use the terms “data representation” and “schema” interchangeably, with “schema” denoting its database management context. In this context, a schema serves as a blueprint outlining the structure, organization, and relationships of data within a database system. It encompasses key details such as tables, fields, data types, and constraints that define the stored data. To systematically illustrate schema differences among hospitals associated with different health systems, we adopted the methodology outlined in reference [ 27 ] for schema integration, which offers a valid approach for comparing distinct data representations. The concept of schema integration encompasses four common categories: (1) identical: hospitals within the same health system adhere to this concept as their representations are identical; (2) equivalent: while hospitals in health system “A” may present different representations from those in health system “B,” they possess interchangeable columns; (3) compatible: in cases where hospitals across different health systems are neither identical nor equivalent, the modeling constructs, designer perception, and integrity constraints do not contradict one another; and (4) incompatible: in situations where hospitals within different health systems demonstrate contradictory representations, distinct columns exist for each health system due to specification incoherence.

Our analysis focused on health systems in Florida that encompassed a minimum of 4 main hospitals, using the most up-to-date data available on their respective websites. Within this scope, we identified 8 health systems with at least 4 main hospitals, of which 88% (7/8) of health systems had published machine-readable files on their websites. Consequently, our analysis included 65% (36/55) of hospitals that possessed machine-readable files available on their websites. To facilitate further investigation by interested researchers, we have made the analyzed data accessible on a cloud-based platform. During our analysis, we meticulously extracted the schema of each health system by closely scrutinizing the hospitals associated with each health system, capturing key details such as tables, fields, and data types. Subsequently, we compiled a comprehensive master field name table trying to have the same data type and field names that make it easier for machines to retrieve information. We elaborate on the master field names table in greater detail within the results section.

Value for Users

Question 1 (pt awareness).

Based on the responses, it is evident that participants need to be made aware of the PT legislation. Among the participants, 64% (49/76) reported that they had not heard about the legislation. However, they believe it is important to know the service price before receiving it—response charts are provided in Multimedia Appendix 3 .

Question 2 (Human Usability of PT Information)

Based on the responses to scenarios, the average number of correct responses is not equal between the 2 groups, that is, the treatment group (mean 1.23, SD 1.30) found more correct answers than the control group (mean 2.76, SD 0.58; t 65 =6.46; P <.049; d =1.52). The t tests (2-tailed) for the other questions in the experiment are in Multimedia Appendix 4 .

These suggest that current files on hospitals’ websites are not consumer-friendly, and participants find it challenging to estimate out-of-pocket costs for a desired service. For this reason, in addition to making the files easier to use, this information should also include thorough documentation that explains what each column represents, up to what amount an insurer covers for a specific service, or the stated price covers up to how many days of a particular service, that is, “contracting method.” For example, based on consulting with one of the senior network analysts of Florida Blue, some prices for a service like DRG 807 are presented as per diem costs, and based on the current information on these files, it cannot be recognizable without having comprehensive documentation for them.

Value for Machines

After carefully reviewing all machine-readable file schemas, we create a master field name table, including the available field names in machine-readable files ( Table 2 ). According to Table 2 , the first column represents master field names that we came up with, and the following columns each represent hospitals within a health system. The “✓” mark shows that hospitals within a health system have identical field names as we consider as master field names and the “written” cells show equivalent field names, meaning that hospitals within that health system use different field names—we write what they use in their representation—while the content is equivalent to what we select as the master field name. The “❋” mark means that although hospitals within health system #2 provide insurer names and plans in their field names, some codes make those columns unusable for machines to recognize them the same as master field names. We also include the type of field names for all representations in parentheses.

a As noted previously, since we focus on the health system level instead of the hospital level, our schema does not have hospital-level information; however, it would be beneficial to add hospital information to the table.

b ✓: it means the given master field name in that row appears on the given health system file in that column.

c str: shows “string” as the data type.

d int: shows “integer” as the data type.

e CPT: Current Procedural Terminology.

f HCPCS: Health care Common Procedure Coding System.

g Not applicable.

h Apr: all patients refined.

i DRG: Diagnosis-Related Group.

j Ms: Medicare severity.

k CDM: charge description master.

l UB: uniform billing.

m float: it shows “float” as the data type.

n ❋: it means that although hospitals within health system #2 provide insurer names and plans in their field names, some codes make those columns unusable for machines to recognize them the same as master field names.

We did reverse engineering and drew entity-relationship diagrams (ERDs) for each hospital based on their data representation. However, as hospitals within the same health system have the same ERDs, we only include 1 ERD for each health system ( Figure 1 ). According to Figure 1 , although hospitals have tried to follow an intuitive structure, we can still separate them into three groups: (1) group I: all hospitals within this group have several columns for different insurers. As shown in the ERDs, we decided to have a separate entity, called “Insurance” for this group; (2) group II: all hospitals within this group have many sheets, and each sheet belongs to a specific insurer with a specific plan. As shown in the ERDs, we decided to create an “Insurance_Name” entity for this group’s ERD to show the difference in data representation; and (3) group III: all hospitals within this system have a “payer” column which includes the names of insurers without their plans. As shown in the ERDs, we decided to put this column as an attribute in the “Service” entity, and do not have an “Insurance” entity for this group’s ERD.

In conclusion, although most hospitals have adopted group I logic for data representation, for full similarity, a standard representation with the same intuitive field names (like what we suggest as the master field name; Table 2 ) should be proposed so that it can cover all systems’ data representations and be used as machine-readable file, for at least machine benefits. Mainly, standardization in the format and semantics of the provided data can help substantially in making the data more machine friendly.

Comparison With New CMS Guidelines

Recently, CMS has published guidelines regarding the PT legislation [ 28 ]. The most recent CMS guideline is a step forward in ensuring standardization but is still only recommended and is not mandatory. These guidelines exhibit overlaps with our fields in Table 2 , with slight differences attributed to granularities. Our observation reveals that hospitals within the same health system adopt a uniform schema. Therefore, our suggested schema operates on the granularity of health systems rather than individual hospitals.

The recent CMS guidelines allocate 24% (6/25) of field names specifically to hospital information, encompassing details such as “Hospital Name,” “Hospital File Date,” “Version,” “Hospital Location,” “Hospital Financial Aid Policy,” and “Hospital Licensure Information.” These details, absent in current hospital files, are crucial for informed decision-making. As noted previously, since we focus on the health system level instead of the hospital level, our schema does not have hospital-level information; however, it would be beneficial to add hospital information to the tables.

Our analysis reveals that the 11 field names in Table 2 align with the field names in the new CMS guidelines, demonstrating a substantial overlap of 58% (11/19). The corresponding CMS field names (compatible with our schema) include “Item or Service Description (Description or CDM Service Description),” “Code (Code),” “Code Type (Code Type),” “Setting (Patient Class),” “Gross Charge (Gross Charge),” “Discounted Cash Price (Discounted Cash Price),” “Payer Name (Insurer Name),” “Plan Name (Insurer Plan),” “Payer Specific Negotiated Charge: Dollar Amount (Price),” “De-identified Minimum Negotiated Charge (Min Negotiated Rate),” and “De-identified Maximum Negotiated Charge (Max Negotiated Rate).” Additionally, both our schema and the new CMS guidelines propose data types for each field name.

In our schema, which represents current hospitals’ files, there are 5 field names absent in the new CMS guidelines “Revenue Description,” “Revenue Code,” “Package/Line Level,” “Procedure ID,” and “Self Pay.” Conversely, the new CMS guidelines introduce 8 additional field names “Billing Class,” “Drug Unit of Measurement,” “Drug Type of Measurement,” “Modifiers,” “Payer Specific Negotiated Charge: Percentage,” “Contracting Method,” “Additional Generic Notes,” and “Additional Payer-Specific Notes.” We regard these new field names as providing further detailed information and enhancing consumer decision-making. If hospitals within a health system adopt consistent formats and can map their formats to the new CMS guidelines clearly in a mapping document they also provide, this can be more useful than the current optional guideline that is suggested.

In summary, since our analysis is based on the current data schema that hospitals have in place, we believe the schema we put out is easier to implement with minimal change to what the hospitals are currently doing. However, given the recent CMS guidelines, we recommend adding 8 additional fields as well as hospital-specific information.

Implications

The PT legislation aims to enable informed decision-making, reduce out-of-pocket expenses, and decrease overall health care expenditures. This study investigates the usage of current files by individuals and machines. Our results, unfortunately, suggest that PT data—as currently reported—appear to be neither useful for patients nor machines, raising important questions as to what these appear to be achieving today. Moreover, the findings indicate that even individuals with basic computer knowledge struggle with the usability of these files, highlighting the need for significant revisions to make them consumer-friendly and accessible to individuals of all technical proficiency levels. Additionally, inconsistencies in data representation between hospitals affiliated with different health systems pose challenges for machines, necessitating schema design improvements and the implementation of a standardized data representation. By addressing these concerns, PT legislation can achieve consistency and enhance machine readability, thus improving its effectiveness in promoting informed decision-making and reducing health care costs.

Although the official announcement of PT legislation is recent, prior studies [ 15 - 17 ] have attempted to evaluate the usability of PT, while subsequent studies [ 19 - 22 ] have examined the effectiveness of PT tools following the announcement. However, despite the introduction of PT rules, it appears that the usability of these files has not undergone significant improvements, indicating the necessity for proactive measures from responsible executives to ensure the effectiveness of this legislation. Our analysis of this matter emphasizes 2 primary factors—a lack of awareness among stakeholders and the challenges associated with using files due to inconsistencies in their format and representation.

As of April 2023, the CMS has issued over 730 warning notices and 269 requests for Corrective Action Plans. A total of 4 hospitals have faced Civil Monetary Penalties for noncompliance, and these penalties are publicly disclosed on the CMS website. The remaining hospitals subjected to comprehensive compliance reviews have either rectified their deficiencies or are actively engaged in doing so. While we acknowledge these efforts to comply with PT rules, our research revealed a notable disparity in data representation among hospitals affiliated with different health systems. Consequently, we focused on schema design and proposed the implementation of a master field name that encompasses a comprehensive data representation derived from an analysis of 36 hospitals. Standardizing the data representation across all health systems’ machine-readable files will effectively address concerns about consistency. Therefore, significant modifications are required for the PT legislation to enhance machine readability and provide clearer guidance on the design and structure of the files’ schema. If the hospital-provided information is consistent and of high quality, PT tools provided by health insurers may be able to estimate an individual’s total expenses more accurately.

Limitations

Our objective was to have an equal number in both groups. However, in the case of the group tasked with obtaining information from the hospitals’ websites, most did not finish the task and dropped out without completing it. This occurred because the task of retrieving the cost from the hospitals’ websites in its current form is complex, as indicated by feedback from some participants. Only 19% (13/67) completed the task in that group (control group). Although this is a limitation of the study, it also highlights the complexity of obtaining cost information from hospitals’ websites in the current form. In the treatment group, 81% (54 out of 67) of participants completed the task of retrieving the data, and the completion percentage was much higher.

Conclusions

Due to the poor usability and inconsistency of the formats, we, unfortunately, did not find evidence that the PT rule as implemented currently is useful to consumers, researchers, or policy makers (despite the legislation’s goals that files are “consumer-friendly” and “machine-readable”). As 1 solution, we suggest a master field name for the data representation of machine-readable files to make them consistent, at least for the machines. Building tools that enable customers to estimate out-of-pocket costs is facilitated by having consistent machine-readable files across all health systems, which can be considered as future work for researchers and companies to help the PT rule reach its main goal, which is providing useful information for patients and reducing health care expenditures. In addition, another worthwhile approach to reducing some of the exorbitant health care costs in the United States would be to integrate clinical decision support tools into the providers’ workflow, triggered by orders for medications, diagnostic testing, and other billable services. In this regard, Bouayad et al [ 29 ] conducted experiments with physicians to demonstrate that PT, when included as part of the system they interact with, such as clinical decision support integrated into electronic health record systems, can significantly aid in cost reduction. This is a promising direction for practice but needs to be implemented carefully to avoid unanticipated consequences, such as scenarios where cost is incorrectly viewed as a proxy for quality, or where the use of this information introduces new biases for physicians and patients.

Conflicts of Interest

None declared.

Example of Excel format of hospitals’ files and our created Excel file.

Survey questions and experiment scenarios.

Participants’ responses chart regarding price transparency awareness.

The t test analysis regarding human usability of price transparency information based on participants’ responses.

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Abbreviations

Edited by S He; submitted 07.07.23; peer-reviewed by KN Patel, R Marshall, G Deckard; comments to author 03.12.23; revised version received 21.01.24; accepted 26.02.24; published 29.03.24.

©Negar Maleki, Balaji Padmanabhan, Kaushik Dutta. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 29.03.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.