Iveta Simera

A catalogue of reporting guidelines for health research

Eur J Clin Invest 2010; 40 (1): 35–53

Guidance for Developers of Health Research Reporting Guidelines

David Moher and colleagues from the EQUATOR network offer guidance and recommended steps for developing health research reporting guidelines.

EQUATOR: reporting guidelines for health research

Despite the effort of researchers, editors and peer reviewers, the quality of health-research reporting in journal articles is unsatisfactory.1-6 Guidelines that specify a minimum set of items for reporting can improve the accuracy and transparency of publications, thus facilitating easier and more reliable appraisal of quality and relevance. During the past 10 years several internationally respected guidelines for the reporting of health research have been developed.7-10 However, those guidelines are still not widely supported by medical journals11, 12 or adhered to by researchers, and thus their potential impact is lessened. To remedy this situation the UK National Knowledge Service provided funding to start the EQUATOR project (Enhancing the QUAlity and Transparency Of health Research). This initiative seeks to improve the reliability of medical publications by promoting transparent and accurate reporting of health research. This movement grew out of the work of CONSORT9 and other groups. EQUATOR is an umbrella for all areas of health-research reporting. The network aims to become a global centre that provides resources and training, and which assists in the development, dissemination, and implementation of robust reporting guidelines. EQUATORs strategic plan reflects the needs of its major stakeholders: developers of reporting guidelines, researchers, journal editors, peer-reviewers, and research-funding bodies. One of the first activities was to identify existing reporting guidelines to see how they were developed. The development methods of most guidelines were broadly similar, but with wide variation in important details. Development usually took a long time and only half the groups had strategies for dissemination and implementation of their guidelines. The difficulty of securing sufficient funding to develop, assess, and disseminate guidelines was widely acknowledged as a major problem. The initial survey and discussions with the main stakeholders helped us to prioritise future activities. First, we developed an internet-based resource centre, which can be freely accessed on our website.13 At present, it provides a collection of available reporting guidelines. In the future, the website will also host other resources for authors of research articles, editors, peer-reviewers, and developers of guidelines, including a comprehensive digital library for health-research reporting, guidance for the development of robust reporting guidelines, tools to facilitate their use, and educational materials. The availability of good reporting guidelines is not sufficient for the improvement of the quality of reporting. Our second priority will be active promotion of such guidelines and their use, by developing and running training for editors, peer-reviewers, and authors. The courses will concentrate on the important factors of research reporting and the efficient use of reporting guidelines. Figure 1 EQUATOR Network logo Poor reporting reflects a collective failure of those involved. Collaboration with and the support of influential medical journals are vital for the success of this project. Benefits will be equally split between both communities—users will benefit from improved reliability of scientific information and journals will benefit from increased loyalty of their readers attracted by improved accuracy and reliability of reports. The EQUATOR network will regularly monitor how journals implement reporting guidelines. We will annually audit the quality of reporting across the health-research literature and hope to document gradual improvements. Sufficient funding is a necessary requirement for the development and implementation of robust reporting guidelines and widespread promotion of good reporting of research. In view of how much money funding agencies spend on health research, their lack of interest in ensuring that this research is reported accurately is deeply disappointing. Good reporting is not an optional extra; it is an essential component of research. Funding bodies should recognise this and support initiatives such as EQUATOR that aim to improve the current situation. The EQUATOR Network will hold its official launch meeting on June 26, 2008, in London, UK. The meeting will focus on better understanding of problems associated with health-research reporting and use of reporting guidelines, and on finding potential solutions to improve the health-research literature.

Helping editors, peer reviewers and authors improve the clarity, completeness and transparency of reporting health research

Inadequate reporting is problematic for several reasons. If authors do not provide sufficient details concerning the conduct of their study, readers are left with an incomplete picture of what was done. As such, they are not able to judge the merits of the results and interpret them. The EQUATOR Network is a new initiative aimed at improving the clarity and transparency of reporting health research.

Describing reporting guidelines for health research: a systematic review

OBJECTIVE To describe the process of development, content, and methods of implementation of reporting guidelines for health research. STUDY DESIGN AND SETTING A systematic review of publications describing health research reporting guidelines developed using consensus. RESULTS Eighty-one reporting guidelines for health research were included in the review. The largest number of guidelines do not focus on a specific study type (n=35; 43%), whereas those that do primarily refer to reporting of randomized controlled trials (n=16; 35%). Most of the guidelines (n=76; 94%) include a checklist of recommended reporting items, with a median of 21 checklist items (range: 5-64 items). Forty-seven (58%) reporting guidelines were classified as new guidance. Explanation documents were developed for 11 (14%) reporting guidelines. Reporting-guideline developers provided little information about the guideline development process. Developers of 50 (62%) reporting guidelines encouraged endorsement, most commonly by including guidelines in journal instructions to authors (n=18; 36%). CONCLUSIONS Reporting-guideline developers need to endeavor to maximize the quality of their product. Recently developed guidance is likely to facilitate more robust guideline development. Journal editors can be more confident in endorsing reporting guidelines that have followed these approaches.

GRIPP2 reporting checklists: tools to improve reporting of patient and public involvement in research

BackgroundWhile the patient and public involvement (PPI) evidence base has expanded over the past decade, the quality of reporting within papers is often inconsistent, limiting our understanding of how it works, in what context, for whom, and why.ObjectiveTo develop international consensus on the key items to report to enhance the quality, transparency, and consistency of the PPI evidence base. To collaboratively involve patients as research partners at all stages in the development of GRIPP2.MethodsThe EQUATOR method for developing reporting guidelines was used. The original GRIPP (Guidance for Reporting Involvement of Patients and the Public) checklist was revised, based on updated systematic review evidence. A three round Delphi survey was used to develop consensus on items to be included in the guideline. A subsequent face-to-face meeting produced agreement on items not reaching consensus during the Delphi process.ResultsOne hundred forty-three participants agreed to participate in round one, with an 86% (123/143) response for round two and a 78% (112/143) response for round three. The Delphi survey identified the need for long form (LF) and short form (SF) versions. GRIPP2-LF includes 34 items on aims, definitions, concepts and theory, methods, stages and nature of involvement, context, capture or measurement of impact, outcomes, economic assessment, and reflections and is suitable for studies where the main focus is PPI. GRIPP2-SF includes five items on aims, methods, results, outcomes, and critical perspective and is suitable for studies where PPI is a secondary focus.ConclusionsGRIPP2-LF and GRIPP2-SF represent the first international evidence based, consensus informed guidance for reporting patient and public involvement in research. Both versions of GRIPP2 aim to improve the quality, transparency, and consistency of the international PPI evidence base, to ensure PPI practice is based on the best evidence. In order to encourage its wide dissemination this article is freely accessible on The BMJ and Research Involvement and Engagement journal websites.

Writing a research article that is “fit for purpose”: EQUATOR Network and reporting guidelines

Clinical practice and public health policy decisions depend on high-quality information about research findings. However, growing evidence shows widespread deficiencies in the reporting of health research studies. Problematic issues include (but are not limited to) non-reporting or delayed reporting of entire studies;1 omission of crucial information in the description of research methods2 and interventions;3 selective reporting of only some outcomes;4 presenting data and graphs in confusing and misleading ways;5 and omissions from or misinterpretation of results in abstracts.6 These deficiencies have serious consequences for clinical practice, research, policy making, and ultimately for patients. We illustrate the seriousness of the problem with several examples. In 1999, Drummond Rennie highlighted several systematic reviews7 8 9 that had identified multiple non-transparent publications of the same trials; this publication bias artificially created an impression of much larger support for the efficacy of studied interventions.10 More recently, Dwan et al summarised the evidence from 16 cohort studies that assessed study publication bias and outcome reporting bias in randomised controlled trials.4 Studies reporting positive or significant results were more likely to be published, and outcomes that were statistically significant were more likely to be fully reported. Also, discrepancies between the publications and original protocols were common: 40–62% of studies had at least 1 primary outcome that was changed, newly introduced, or omitted. Chan and Altman2 assessed reporting of methodological information in 519 randomised trials published in 2000. Fewer than half included an adequate description of the sample size calculation, primary outcomes, random sequence generation, allocation concealment, and handling of attrition (all of which are crucial to assess the validity of trial findings). Evidence is accumulating that use of reporting guidelines can improve the completeness and transparency of publications.11 12 Reporting guidelines specify a minimum set …

Responsible reporting of health research studies: transparent, complete, accurate and timely

Complete, accurate and transparent reporting is an integral part of responsible research conduct. However, many studies have shown that health research publications frequently lack crucial information. Reporting guidelines like the CONSORT Statement help to improve the quality of research reports. Unfortunately, their uptake by journals and authors is still limited and does not maximize their potential. The EQUATOR Network, a new international initiative, leads the effort to promote transparent reporting of research and the use of reporting guidelines. It provides online resources and training relating to the reporting of health research, and assists in the development, dissemination and implementation of reporting guidelines (www.equator-network.org). Poor reporting practices can be decreased only through close collaboration of all parties involved in research and its publication; EQUATOR can facilitate the process.

The EQUATOR Network and reporting guidelines: Helping to achieve high standards in reporting health research studies

Poorly reported research seriously undermines the usability of reported findings and misleads clinicians, researchers, policy makers and, ultimately, patients. Guidelines for reporting health research are available but they are not widely used. The EQUATOR Network is an international initiative that aims to systematically tackle the problems of poor reporting. The main goals of the EQUATOR Network are to improve the clarity, completeness and transparency of scientific publications by providing resources and education relating to the reporting of health research and assisting in the development, dissemination and implementation of robust reporting guidelines.

Does journal endorsement of reporting guidelines influence the completeness of reporting of health research? A systematic review protocol

BackgroundReporting of health research is often inadequate and incomplete. Complete and transparent reporting is imperative to enable readers to assess the validity of research findings for use in healthcare and policy decision-making. To this end, many guidelines, aimed at improving the quality of health research reports, have been developed for reporting a variety of research types. Despite efforts, many reporting guidelines are underused. In order to increase their uptake, evidence of their effectiveness is important and will provide authors, peer reviewers and editors with an important resource for use and implementation of pertinent guidance. The objective of this study was to assess whether endorsement of reporting guidelines by journals influences the completeness of reporting of health studies.MethodsGuidelines providing a minimum set of items to guide authors in reporting a specific type of research, developed with explicit methodology, and using a consensus process will be identified from an earlier systematic review and from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network’s reporting guidelines library. MEDLINE, EMBASE, the Cochrane Methodology Register and Scopus will be searched for evaluations of those reporting guidelines; relevant evaluations from the recently conducted CONSORT systematic review will also be included. Single data extraction with 10% verification of study characteristics, 20% of outcomes and complete verification of aspects of study validity will be carried out. We will include evaluations of reporting guidelines that assess the completeness of reporting: (1) before and after journal endorsement, and/or (2) between endorsing and non-endorsing journals. For a given guideline, analyses will be conducted for individual and the total sum of items. When possible, standard, pooled effects with 99% confidence intervals using random effects models will be calculated.DiscussionEvidence on which guidelines have been evaluated and which are associated with improved completeness of reporting is important for various stakeholders, including editors who consider which guidelines to endorse in their journal editorial policies.