title: Quality of reporting of diagnostic accuracy studies.
abstract: OBJECTIVE
  To evaluate quality of reporting in diagnostic accuracy articles published in 2000 in journals with impact factor of at least 4 by using items of Standards for Reporting of Diagnostic Accuracy (STARD) statement published later in 2003.
  
  
  METHODS
  English-language articles on primary diagnostic accuracy studies in 2000 were identified with validated search strategy in MEDLINE. Articles published in journals with impact factor of 4 or higher that regularly publish articles on diagnostic accuracy were selected. Two independent reviewers evaluated quality of reporting by using STARD statement, which consists of 25 items and encourages use of a flow diagram. Total STARD score for each article was calculated by summing number of reported items. Subgroup analyses were performed for study design (case-control or cohort study) by using Student t tests for continuous outcomes and chi(2) tests for dichotomous outcomes.
  
  
  RESULTS
  Included were 124 articles published in 2000 in 12 journals: 33 case-control and 91 cohort studies. Only 41% of articles (51 of 124) reported on more than 50% of STARD items, while no articles reported on more than 80%. A flow chart was presented in two articles. Assessment of reporting on individual items of STARD statement revealed wide variation, with some items described in 11% of articles and others in 92%. Mean STARD score (0-25 points available) was 11.9 (range, 3.5-19.5). Mean difference in STARD score between cohort studies and case-control studies was 1.53 (95% confidence interval: 0.24, 2.82).
  
  
  CONCLUSIONS
  Quality of reporting in diagnostic accuracy articles published in 2000 is less than optimal, even in journals with high impact factor. Authors, editors, and reviewers should pay more attention to reporting by checking STARD statement items and including a flow diagram to represent study design and patient flow.
authors.affiliation: Institute for Research in Extramural Medicine, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, the Netherlands.
authors.forename: Nynke
authors.initials: N
authors.lastname: Smidt
authors.forename: Anne W S
authors.initials: AW
authors.lastname: Rutjes
authors.forename: Daniëlle A W M
authors.initials: DA
authors.lastname: van der Windt
authors.forename: Raymond W J G
authors.initials: RW
authors.lastname: Ostelo
authors.forename: Johannes B
authors.initials: JB
authors.lastname: Reitsma
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Bossuyt
authors.forename: Lex M
authors.initials: LM
authors.lastname: Bouter
authors.forename: Henrica C W
authors.initials: HC
authors.lastname: de Vet
mesh_terms: D016022:Case-Control Studies; D015331:Cohort Studies; D003933:Diagnosis; D035081:Editorial Policies; D006801:Humans; D010506:Periodicals as Topic / Q000592:standards*; D011643:Publishing / Q000592:standards*; D011786:Quality Control; D012107:Research Design / Q000592:standards*; D012922:Social Change; D012985:Software Design; D014481:United States; D014956:Writing / Q000592:standards