Laura Derbyshire

The SCARE Statement: Consensus-based surgical case report guidelines

INTRODUCTION Case reports have been a long held tradition within the surgical literature. Reporting guidelines can improve transparency and reporting quality. However, recent consensus-based guidelines for case reports (CARE) are not surgically focused. Our objective was to develop surgical case report guidelines. METHODS The CARE statement was used as the basis for a Delphi consensus. The Delphi questionnaire was administered via Google Forms and conducted using standard Delphi methodology. A multidisciplinary group of surgeons and others with expertise in the reporting of case reports were invited to participate. In round one, participants stated how each item of the CARE statement should be changed and what additional items were needed. Revised and additional items from round one were put forward into a further round, where participants voted on the extent of their agreement with each item, using a nine-point Likert scale, as proposed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) working group. RESULTS In round one, there was a 64% (38/59) response rate. Following adjustment of the guideline with the incorporation of recommended changes, round two commenced and there was an 83% (49/59) response rate. All but one of the items were approved by the participants, with Likert scores 7-9 awarded by >70% of respondents. The final guideline consists of a 14-item checklist. CONCLUSION We present the SCARE Guideline, consisting of a 14-item checklist that will improve the reporting quality of surgical case reports.

Preferred reporting of case series in surgery; the PROCESS guidelines

INTRODUCTION Case series have been a long held tradition within the surgical literature and are still frequently published. Reporting guidelines can improve transparency and reporting quality. No guideline exists for reporting case series, and our recent systematic review highlights the fact that key data are being missed from such reports. Our objective was to develop reporting guidelines for surgical case series. METHODS A Delphi consensus exercise was conducted to determine items to include in the reporting guideline. Items included those identified from a previous systematic review on case series and those included in the SCARE Guidelines for case reports. The Delphi questionnaire was administered via Google Forms and conducted using standard Delphi methodology. Surgeons and others with expertise in the reporting of case series were invited to participate. In round one, participants voted to define case series and also what elements should be included in them. In round two, participants voted on what items to include in the PROCESS guideline using a nine-point Likert scale to assess agreement as proposed by the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) working group. RESULTS In round one, there was a 49% (29/59) response rate. Following adjustment of the guideline with incorporation of recommended changes, round two commenced and there was an 81% (48/59) response rate. All but one of the items were approved by the participants and Likert scores 7-9 were awarded by >70% of respondents. The final guideline consists of an eight item checklist. CONCLUSION We present the PROCESS Guideline, consisting of an eight item checklist that will improve the reporting quality of surgical case series. We encourage authors, reviewers, editors, journals, publishers and the wider surgical and scholarly community to adopt these.

External urethral sphincter electromyography in asymptomatic women and the influence of the menstrual cycle.

To investigate by electromyography (EMG), the presence of complex repetitive discharges (CRDs) and decelerating bursts (DBs) in the striated external urethral sphincter during the menstrual cycle in female volunteers with no urinary symptoms and complete bladder emptying.

The SCARE 2018 Statement: Updating Consensus Surgical CAse REport (SCARE) Guidelines

INTRODUCTION The SCARE Guidelines were published in 2016 to provide a structure for reporting surgical case reports. Since their publication, SCARE guidelines have been widely endorsed by authors, journal editors, and reviewers, and have helped to improve reporting transparency of case reports across a range of surgical specialties. In order to encourage further progress in reporting quality, the SCARE guidelines must themselves be kept up to date. We completed a Delphi consensus exercise to update the SCARE guidelines. METHODS A Delphi consensus exercise was undertaken. All members of the previous Delphi group were invited to participate, in addition to researchers who have previously studied case reports, and editors from the International Journal of Surgery Case Reports. The expert group was sent an online questionnaire where they were asked to rate their agreement with proposed changes to each of the 24 items. RESULTS 56 people agreed to participate and 45 (80%) invitees completed the survey which put forward modifications to the original guideline. The collated responses resulted in modifications. There was high agreement amongst the expert group. CONCLUSION A modified and improved SCARE checklist is presented, after a Delphi consensus exercise was completed. The SCARE 2018 Statement: Updating Consensus Surgical CAse REport (SCARE) Guidelines.

Voiding dysfunction after left medial frontal lobe infarction

A 37-year-old right handed man was admitted to hospital after developing sudden onset weakness of his right arm and leg. At admission, he complained of urinary frequency and incontinence, with no prior urinary symptoms. His motor function returned to normal within 36 h. A computerised tomography (CT) scan demonstrated an abnormality in the left medial frontal lobe, and a subsequent magnetic resonance imaging (MRI) scan revealed a left medial frontal infarct involving the anterior cingulate cortex and underlying corpus callosum (Fig. 1a and b). Transoesopageal echocardiogram revealed a patent foramen ovale (subsequently closed surgically). When reviewed by the Neurologists 4 months after presentation, his urinary symptoms had changed to profound hesitancy of micturition, intermittent flow and needing to strain to empty

Response to Letter to the Editor: National Re-Audit of Urology Outpatient Practice in the UK

We would like to thank Messrs Nuttall and ’Brien for their views and to congratulate them n reorganising their service so effectively. Our aper has audited national urology outpatient pracice and has highlighted the discrepancy between roposed and actual workload. This is clearly a sigificant issue but it is also a manifold problem for hich there is no universal and simple solution, specially if we focus on numbers alone. Messrs Nuttall and O’Brien’s comments about edesigning outpatient provision do provide a otential solution to some of the workload probems and there will be areas in the UK where mplementation of this type of practice can be pplied effectively. On the other hand, there will lso be areas where a numerical shortfall in peronnel is an important factor and this should not be isregarded. We should remember that the quality of the atient experience is of particular importance. Ini-