Barriers to reporting guideline adherence in point-of-care ultrasound research: a cross-sectional survey of authors and journal editors

Barriers to reporting guideline adherence in point-of-care ultrasound research: a cross-sectional survey of authors and journal editors

Reviewer: Assoc Prof Tristan Reddan, FASA | ASA SIG: Research

Authors: Prager R, Gagnon L, Bowdridge J, Unni RR, McGrath TA, Cobey K, Bossuyt PM & McInnes MDF

Why the study was performed

The Enhancing the Quality and Transparency of Health Research (EQUATOR) Network publishes reporting guidelines for a variety of different research methods (equatornetwork.org).[1] Reporting guidelines were borne of a desire for honest, appropriate, and transparent reporting of findings for the benefit of patients.[2] One such guideline is the Standards of Reporting of Diagnostic Studies (STARD), most recently published in 2015. The STARD guidelines are a list of items that should be included in manuscripts reporting diagnostic accuracy studies that generally adhere to the IMRaD framework (Introduction, Methods, Results, and Discussion). Given the role sonography plays in diagnostic imaging, these guidelines are particularly relevant to sonographers when reporting or reading research findings. Many journals encourage but do not mandate the use of the guidelines.

With the proliferation of point-of-care ultrasound (PoCUS), there have been a proportionate number of diagnostic accuracy studies into the utility of PoCUS in various clinical settings. The authors of this study sought to determine the barriers to adhering to the STARD guidelines in the PoCUS literature.

How the study was performed

Two online surveys were used for data collection. One was sent to the authors (first and corresponding) of published diagnostic accuracy manuscripts, and the other to the editors-in-chief of the journals in which these articles were published. Publications between 2016 and 2019 were included and identified in a previous study in an acute care setting.[3] The surveys sought responses to the respondents’ knowledge, attitudes, and behaviours related to adherence to the STARD 2015 guidelines.

What the study found

Response rates were 26% (18/69) and 24% (5/21) for authors and editors, respectively. Most (67%) investigators were aware of STARD 2015. All respondents agreed incomplete reporting limited generalisability and assessment of bias. STARD being limited to only English language submissions, and the time required to adhere to the guidelines were perceived as barriers by authors. Authors and editors both reported that peer reviewers should be responsible for complete reporting. Only one editor reported returning submissions to authors without an accompanying STARD checklist.

Relevance to clinical practice

While the study’s focus is PoCUS, this is readily generalisable to sonographers as some of us work in this professional domain, and we should be aware of the accuracy of PoCUS in developing disciplines in our respective systems. The study highlights the importance of complete reporting to prevent bias and permit the generalisability of results. Those sonographers engaged in peer review should be aware of their responsibilities in relation to reporting guidelines.

The study highlights the importance of complete reporting to prevent bias and permit generalisability of results

1. Altman DG, Simera I. A history of the evolution of guidelines for reporting medical research: the long road to the EQUATOR Network. J R Soc Med. 2016 Feb 15;109(2): 67–77.

2. Rennie D. A tribute to Douglas G. Altman, DSc. JAMA – J Am Med Assoc. 2019 Apr 23;321(16): 1621.

3. Prager R, Bowdridge J, Kareemi H, Wright C, McGrath TA, McInnes MDF. Adherence to the Standards for Reporting of Diagnostic Accuracy (STARD) 2015 Guidelines in Acute Point-of-Care Ultrasound Research. JAMA Netw Open. 2020 May 1;3(5): e203871–e203871.