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From the Institute for Research in Extramural Medicine (N.S., D.A.W.M.v.d.W., R.W.J.G.O., L.M.B., H.C.W.d.V.), VU University Medical Center, Amsterdam; and Department of Clinical Epidemiology & Biostatistics (A.W.S.R., P.M.B., J.B.R.), Academic Medical Center, University of Amsterdam, The Netherlands.
Address correspondence and reprint requests to Dr. Nynke Smidt, Department of Clinical Epidemiology & Biostatistics, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands; e-mail: n.smidt{at}amc.uva.nl
Objective: To assess whether the quality of reporting of diagnostic accuracy studies has improved since the publication of the Standards for the Reporting of Diagnostic Accuracy studies (STARD statement).
Methods: The quality of reporting of diagnostic accuracy studies published in 12 medical journals in 2000 (pre-STARD) and 2004 (post-STARD) was evaluated by two reviewers independently. For each article, the number of reported STARD items was counted (range 0 to 25). Differences in completeness of reporting between articles published in 2000 and 2004 were analyzed, using multilevel analyses.
Results: We included 124 articles published in 2000 and 141 articles published in 2004. Mean number of reported STARD items was 11.9 (range 3.5 to 19.5) in 2000 and 13.6 (range 4.0 to 21.0) in 2004, an increase of 1.81 items (95% CI: 0.61 to 3.01). Articles published in 2004 reported the following significantly more often: methods for calculating test reproducibility of the index test (16% vs 35%); distribution of the severity of disease and other diagnoses (23% vs 53%); estimates of variability of diagnostic accuracy between subgroups (39% vs 60%); and a flow diagram (2% vs 12%).
Conclusions: The quality of reporting of diagnostic accuracy studies has improved slightly over time, without a more pronounced effect in journals that adopted the STARD statement. As there is still room for improvement, editors should mention the use of the STARD statement as a requirement in their guidelines for authors, and instruct reviewers to check the STARD items. Authors should include a flow diagram in their manuscript.
Editorial, see page 740
Supported by grant from The Netherlands Organisation for Health Research and Development (ZonMw).
Disclosure: The funding agency did not play a role in the design and conduct of the study, collection, management, analysis, and interpretation of the data, nor in the preparation, review, or approval of the manuscript. The authors report no conflicts of interest.
Received February 15, 2006.
Accepted in final form June 28, 2006.
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