The EQUATOR Network: promoting the transparent and accurate reporting of research

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At four meetings each year, the Editorial Board of Mac Keith Press review the preceding 3 months’ issues of the journal. One board member takes the role of primary reviewer for each issue and other members contribute to the subsequent discussion. While there are frequently complimentary comments about papers published in DMCN, this reviewing is a form of continuous quality improvement. For example, criticisms of papers are often levelled because they contain bewilderingly large tables, an unnecessary proliferation of acronyms (as could be said about this piece), or other presentational challenges. Occasionally, however, the process reveals published papers that lack some aspect of methodological rigor, present inadequate information, or do not discuss the findings in the broader context of what is known about the topic. This occurs despite the editorial and peer review processes that challenge authors to explain and interpret their research appropriately. Such occurrences are rare, but frustrating nevertheless.

A new resource was formally launched in June this year, called Enhancing the Quality and Transparency of Health Research (EQUATOR; http://www.equator-network.org). The initiative grew from the successful Consolidated Standards of Reporting Trials (CONSORT; http://www.consort-statement.org)1 guidelines for reporting randomized controlled trials and seeks to promote the transparent and accurate reporting of all health research. The EQUATOR Network is directed by leading experts in health research methodology and brings together guideline developers, journal editors, peer reviewers, and research funding bodies, all of whom have a vested interest in improving the quality of research reporting. One of the main objectives is to provide guidelines to improve the quality of research publications that will be useful for authors, peer reviewers, and editors. Although the website is under development, there are links to CONSORT and to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE; http://www.strobe-statement.org) guidelines, as well as guidelines for diagnostic accuracy studies (STARD), systematic reviews, and meta-analyses (QUORUM and MOOSE).

The CONSORT guidelines are now well established. Many journals and reviewers use CONSORT criteria to judge the quality of reports of trials; hence authors are disposed to using the same standards to construct the content of their papers. Development of the CONSORT guidelines went through several iterations before the current version. Adoption of CONSORT by journals was associated with improvements in the quality of reports of randomized controlled trials, judged by the inclusion of expected standard items, and whether ‘allocation concealment’, a vital methodological component for reducing bias in randomized controlled trials, was clearly reported. More recently, these standards have been extended to set out what information should be presented in abstracts for conference proceedings and journal articles. The authors emphasize that, in many instances, either due to resource limitations or restricted access to full papers, the abstract is all that is read. The same principle of clarity and including adequate and appropriate detail, applies to abstracts from all types of health research, not just clinical trials.

The STROBE guidelines are for cohort, case-control, and cross-sectional studies. While they are not prescriptive, for each type of observational study, STROBE guidelines recommend what information would be expected to be presented and where in the paper such information would be expected to be found. This permits the reader to assess whether there may be any biases in the study design, for instance in the way participants were selected, whether comparisons were appropriate, or if any other potential sources of observer or measurement biases exist. Whilst the STROBE guidelines are clearly well conceived, it has been suggested that refinements may be required, and the developers invite, and have published, feedback on their website.

In writing this editorial, my aim is to encourage those who write and review papers for the journal to look at and consider the utility of reporting guidelines. At the Editorial meeting in July, board members endorsed the principles behind the reporting guidelines and the following actions were agreed. First, the instructions to authors will be amended to include reference to The EQUATOR Network and authors will be strongly advised to use the reporting guidelines when preparing their manuscripts. Second, peer reviewers will be made aware of the guidelines when being invited to review for the journal, and asked to consider using an appropriate checklist when making their quality assessment. A major incentive for authors to report their research in a complete, transparent, and accurate manner will be to make the peer reviewers work easier. This may in some instances make publication more likely and, perhaps, even hasten the process.

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