The quality of diagnostic accuracy studies since the STARD statement: has it improved?

OBJECTIVE: To assess whether the quality of reporting of diagnostic accuracystudies 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 tworeviewers independently. For each article, the number of reported STARD items wascounted (range 0 to 25). Differences in completeness of reporting betweenarticles published in 2000 and 2004 were analyzed, using multilevel analyses.RESULTS: We included 124 articles published in 2000 and 141 articles published in2004. Mean number of reported STARD items was 11.9 (range 3.5 to 19.5) in 2000and 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 moreoften: methods for calculating test reproducibility of the index test (16% vs35%); 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 improvedslightly over time, without a more pronounced effect in journals that adopted theSTARD statement. As there is still room for improvement, editors should mentionthe 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 flowdiagram in their manuscript.