Abstract
Incomplete reporting of diagnostic accuracy research impairs assessment of risk of bias and limits generalizability. Point-of-care ultrasound has become an important diagnostic tool for acute care physicians, but studies assessing its use are of varying methodological quality. To assess adherence to the Standards for Reporting of Diagnostic Accuracy (STARD) 2015 guidelines in the literature on acute care point-of-care ultrasound. MEDLINE was searched to identify diagnostic accuracy studies assessing point-of-care ultrasound published in critical care, emergency medicine, or anesthesia journals from 2016 to 2019. Studies were evaluated for adherence to the STARD 2015 guidelines, with the following variables analyzed: journal, country, STARD citation, STARD-adopting journal, impact factor, patient population, use of supplemental material, and body region. Data analysis was performed in November 2019. Seventy-four studies were included in this systematic review for assessment. Overall adherence to STARD was moderate, with 66% (mean [SD], 19.7 [2.9] of 30 items) of STARD items reported. Items pertaining to imaging specifications, patient population, and readers of the index test were frequently reported (>66% of studies). Items pertaining to blinding of readers to clinical data and to the index or reference standard, analysis of heterogeneity, indeterminate and missing data, and time intervals between index and reference test were either moderately (33%-66%) or infrequently (<33%) reported. Studies in STARD-adopting journals (mean [SD], 20.5 [2.9] items in adopting journals vs 18.6 [2.3] items in nonadopting journals; P = .002) and studies citing STARD (mean [SD], 21.3 [0.9] items in citing studies vs 19.5 [2.9] items in nonciting studies; P = .01) reported more items. Variation by country and journal of publication were identified. No differences in STARD adherence were identified by body region imaged (mean [SD], abdominal, 20.0 [2.5] items; head and neck, 17.8 [1.6] items; musculoskeletal, 19.2 [3.1] items; thoracic, 20.2 [2.8] items; and other or procedural, 19.8 [2.7] items; P = .29), study design (mean [SD], prospective, 19.7 [2.9] items; retrospective, 19.7 [1.8] items; P > .99), patient population (mean [SD], pediatric, 20.0 [3.1] items; adult, 20.2 [2.7] items; mixed, 17.9 [1.9] items; P = .09), use of supplementary materials (mean [SD], yes, 19.2 [3.0] items; no, 19.7 [2.8] items; P = .91), or journal impact factor (mean [SD], higher impact factor, 20.3 [3.1] items; lower impact factor, 19.1 [2.4] items; P = .08). Overall, the literature on acute care point-of-care ultrasound showed moderate adherence to the STARD 2015 guidelines, with more complete reporting found in studies citing STARD and those published in STARD-adopting journals. This study has established a current baseline for reporting; however, future studies are required to understand barriers to complete reporting and to develop strategies to mitigate them.
Highlights
Point-of-care ultrasound (POCUS) has become an important part of the diagnostic arsenal for the contemporary acute care physician.[1,2,3,4,5,6] In contrast to consultative ultrasound, where a scan is performed by a technologist and later interpreted by a radiologist, POCUS can diagnose abnormal physiology and pathology at the bedside
Overall, the literature on acute care point-of-care ultrasound showed moderate adherence to the Standards for Reporting of Diagnostic Accuracy (STARD) 2015 guidelines, with more complete reporting found in studies citing STARD and those published in STARD-adopting journals
Studies citing STARD and those published in journals endorsing STARD had a higher number of reported items. Meaning These findings suggest that adherence of point-of-care ultrasound research to the STARD 2015 guidelines is moderate, which may limit the ability to detect bias in individual studies and prevent appropriate translation of research into clinical practice
Summary
Point-of-care ultrasound (POCUS) has become an important part of the diagnostic arsenal for the contemporary acute care physician.[1,2,3,4,5,6] In contrast to consultative ultrasound, where a scan is performed by a technologist and later interpreted by a radiologist, POCUS can diagnose abnormal physiology and pathology at the bedside. Studies of diagnostic accuracy can be of heterogeneous methodological quality and have variable completeness of reporting.[18] Incomplete reporting can limit the ability to detect bias, determine generalizability of study results, and reproduce research. This leads to the inability to appropriately translate research into clinical practice. Incomplete reporting can prevent informative and unbiased systematic reviews and meta-analyses from being performed.[19,20] As the body of literature surrounding POCUS continues to grow, any deficiencies in reporting must be identified with the aim of implementing knowledge translation strategies to correct them
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