The first thing that strikes you when looking at any of the guidelines on medical research is the contrived acronyms, starting right from QUOROM, short for QUality Of Reporting Of Meta-analyses—perhaps a desperate effort, even taking the ‘o’s from a preposition (‘of’) and making you wonder whether the acronym came first. Another such acronym is EQUATOR, for Enhancing the QUAlity and Transparency Of health Research. CONSORT, short for consolidated standards of reporting trials, probably being the oldest, set the trend, to be followed by many others, such as STROBE (STrengthening the Reporting of OBservational studies in Epidemiology), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials), and STARD (STAndards for the Reporting of Diagnostic accuracy studies), to name some of the more prominent ones, all of which can be considered as medical research guidelines or, more specifically, medical research reporting guidelines.
The EQUATOR Network, which grew out of CONSORT and other similar groups, seeks to “improve the reliability and value of published health research literature by promoting transparent and accurate reporting and wider use of robust reporting guidelines”. The sets of medical research guidelines – each set with its acronym – essentially seek to extend this objective, each focusing on a different aspect: CONSORT focuses on randomized trials; STROBE, on observational studies; PRISMA, on systematic reviews; SPIRIT, on study protocols; and STARD, on diagnostic or prognostic studies.
All the guidelines are regularly updated and many have developed separate ‘extensions’: for example, the CONSORT-AI (Consolidated Standards of Reporting Trials–Artificial Intelligence) extension is applicable to evaluations of clinical trials using AI. The guidelines are usually compatible and are even developed as a collaborative effort between the entities or organizations responsible for each of the guidelines. CONSORT-AI, for instance, was developed in parallel with another on protocols for clinical trials, namely SPIRIT-AI (Standard Protocol Items: Recommendations for Interventional Trials–Artificial Intelligence).
Several recent articles have reviewed the scope, applicability, and salient features of these guidelines, and the present article does not propose to add to those. Instead, it offers some tips on how researchers can comply with the relevant guidelines and indicate as much in their manuscripts, all the more so because many journals insist that authors certify such compliance at the time of submission.
1. Choose the applicable guidelines
The applicable guidelines also vary with the type of manuscript: PRISMA, for instance, are applicable to systematic reviews and meta-analyses—if your manuscript reports original research or is a case study, PRISMA guidelines are irrelevant, whereas if your manuscript reports a randomized trial with adequate controls, the study should comply with the CONSORT guidelines. If you have evaluated the accuracy of a diagnostic method, the study needs to be compliant with STARD. And when it comes to writing a paper, STROBE guidelines are believed to be particularly helpful, because they provide examples of why, and how, specific components of an observational study should be reported.
2. Choose the guidelines early on
The guidelines are not so much for reporting medical research as for designing the studies in the first place so that the results of such studies are statistically valid. The validity, in turn, is based on such considerations as the sampling method, sample size, the number of replications, and maintaining a ‘control’ to ensure that the results of the study are in fact those due to the intervention being studied. The guidelines also include statistical tests to be used in analysing the results.
3. Check the target journal’s requirements
The guidelines represent ideals; in practice, whether to make compliance mandatory, what guideline(s) to choose, and how rigorously to enforce them are matters left to the journal. And even when a journal insists that authors, at the time of submission, should certify such compliance, the journal’s editors or even peer reviewers may lack the necessary expertise to ascertain whether the guidelines for reporting research have indeed been adhered to. Often, this compliance is demanded by journals to ensure that the research findings are reported in a manner clear and complete enough for readers to understand or other researchers include in future meta-analyses.
4. Persevere in your attempts to publish
Finally, given the differences among journals in terms of their insistence that authors adhere to the relevant guidelines, do not lose heart if your paper is turned down for want of such compliance. You could always try another journal. Take heart from the following statistics: of 1052 manuscripts rejected by Academic Emergency Medicine, nearly 66% were subsequently published elsewhere, in a total of 229 journals,1 and of 254 manuscripts rejected by the American Journal of Roentgenology, 64% were later published in 30 radiologic and 27 non-radiologic journals.2
As an author of a manuscript who seeks to be compliant with the appropriate medical research guidelines or medical research reporting guidelines, one starting point is to educate yourself. Familiarize yourself thoroughly with all the guidelines relevant to your study. Read up on them, consult peers and senior researchers on how to plan your research/writing to comply with these guidelines, or enroll for courses that cover these topics, like this R Upskill course on ‘Clinical research methodology and tips for publishing medical research’.
References
- Grant, W. D. & Cone, D. C. If at first you don’t succeed: The fate of manuscripts rejected by Academic Emergency Medicine. Acad. Emerg. Med. Off. J. Soc. Acad. Emerg. Med. 22, 1213–1217 (2015).
- Chew, F. S. Fate of manuscripts rejected for publication in the AJR. AJR Am. J. Roentgenol. 156, 627–632 (1991).
