Assessment of Standards for Reporting of Diagnostic Accuracy (STARD) 2015 guideline adherence in medical imaging diagnostic accuracy studies published in 2023

Background and objective: The Standards for Reporting of Diagnostic Accuracy (STARD) 2015 guideline facilitates evaluation of key aspects of diagnostic test accuracy (DTA) studies and their findings, including the risk of bias and applicability of findings.

Objective: To evaluate the completeness of reporting in medical imaging DTA research in a sample of studies published in 2023.

Methods: A systematic search of Medline, Embase, and the Cochrane Library was performed to identify medical imaging DTA studies published between January and June 2023 that assessed one or more index imaging tests compared to a reference standard and reported test performance using relevant outcome measures. Completeness of reporting amongst the included studies was assessed using the 30-item STARD-2015 guideline. Multiple linear regression was subsequently performed to identify study characteristics associated with more complete reporting.

Results: A total of 116 studies were included in our analysis with a median journal impact factor of 2.7 (range 0.9-19.7). The mean number of items reported was 17.5/30 (58%, SD 2.2). Items that were infrequently reported (reported in less than 33% of included studies) included items 9 ('whether participants formed a consecutive, random or convenience series'), 13.2 ('whether clinical information and index test results were available to the assessors of the reference standard'), 15 ('how indeterminate index test or reference standard results were handled'), 16 ('how missing data on the index test and reference standard were handled'), 22.1 ('time interval between the index test and the reference standard'), 22.2 ('clinical interventions between the index test and the reference standard') and 29 ('where the full study protocol can be accessed'). Adherence was significantly higher in journals with a higher than median journal impact factor (18.1/30 vs 16.8/30 items reported; P < .001).

Conclusion: The completeness of reporting in medical imaging DTA research is moderate and remains relatively static in absolute terms compared to a previous evaluation of studies published in 2016 performed by Hong and colleagues, acknowledging differences in sample study characteristics limit direct comparison. Potential strategies to support more complete reporting in medical imaging DTA research include mandating adherence to the STARD guideline in journal instructions to authors, requiring completed STARD checklists to be submitted alongside all DTA study manuscripts, and integrating quality of reporting assessment as a routine component of the peer review process.