Diagnostic accuracy research in glaucoma is still incompletely reported: An application of Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015.

Alba Miele,Giada Crescioli,Valeria Fameli,Francesco Oddone,Ersilia Lucenteforte,Daniël A Korevaar,Gianni Virgili,Manuele Michelessi

doi:10.1371/journal.pone.0189716

Abstract

BackgroundResearch has shown a modest adherence of diagnostic test accuracy (DTA) studies in glaucoma to the Standards for Reporting of Diagnostic Accuracy Studies (STARD). We have applied the updated 30-item STARD 2015 checklist to a set of studies included in a Cochrane DTA systematic review of imaging tools for diagnosing manifest glaucoma.MethodsThree pairs of reviewers, including one senior reviewer who assessed all studies, independently checked the adherence of each study to STARD 2015. Adherence was analyzed on an individual-item basis. Logistic regression was used to evaluate the effect of publication year and impact factor on adherence.ResultsWe included 106 DTA studies, published between 2003–2014 in journals with a median impact factor of 2.6. Overall adherence was 54.1% for 3,286 individual rating across 31 items, with a mean of 16.8 (SD: 3.1; range 8–23) items per study. Large variability in adherence to reporting standards was detected across individual STARD 2015 items, ranging from 0 to 100%. Nine items (1: identification as diagnostic accuracy study in title/abstract; 6: eligibility criteria; 10: index test (a) and reference standard (b) definition; 12: cut-off definitions for index test (a) and reference standard (b); 14: estimation of diagnostic accuracy measures; 21a: severity spectrum of diseased; 23: cross-tabulation of the index and reference standard results) were adequately reported in more than 90% of the studies. Conversely, 10 items (3: scientific and clinical background of the index test; 11: rationale for the reference standard; 13b: blinding of index test results; 17: analyses of variability; 18; sample size calculation; 19: study flow diagram; 20: baseline characteristics of participants; 28: registration number and registry; 29: availability of study protocol; 30: sources of funding) were adequately reported in less than 30% of the studies. Only four items showed a statistically significant improvement over time: missing data (16), baseline characteristics of participants (20), estimates of diagnostic accuracy (24) and sources of funding (30).ConclusionsAdherence to STARD 2015 among DTA studies in glaucoma research is incomplete, and only modestly increasing over time.

Highlights

Researchers, journal editors and publishers acknowledge the need for adequate reporting of biomedical research as a means of improving the transparency and usability of journal articles [1, 2]
Large variability in adherence to reporting standards was detected across individual STARD 2015 items, ranging from 0 to 100%
An updated version of STARD has recently been published; STARD 2015 includes 9 new items compared to STARD 2003 and consists of a list of 30 essential items that should be reported in all reports of a diagnostic test accuracy (DTA) study [5]

Summary

Introduction

Researchers, journal editors and publishers acknowledge the need for adequate reporting of biomedical research as a means of improving the transparency and usability of journal articles [1, 2]. The performance of these tests in clinical decision-making for detecting glaucoma is still debatable [6] and since their introduction, a large number of studies have been published on their diagnostic ability [7,8,9]. With such a large amount of evidence available, a high quality of reporting is crucial for clinicians to best appreciate the potential for bias and the internal/external validity of such studies [10]. We have applied the updated 30-item STARD 2015 checklist to a set of studies included in a Cochrane DTA systematic review of imaging tools for diagnosing manifest glaucoma

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