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Completeness of reporting for systematic reviews of point-of-care ultrasound: a meta-research study
  1. Ross Prager1,
  2. Michael Pratte2,
  3. Andrew Guy3,
  4. Sudarshan Bala4,
  5. Roudi Bachar5,
  6. Daniel J Kim6,
  7. Scott Millington7,
  8. Jean-Paul Salameh8,
  9. Trevor A McGrath9,
  10. Matthew DF McInnes9,10
  1. 1 Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  2. 2 Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  3. 3 Department of Emergency Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
  4. 4 Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada
  5. 5 Medicine-Surgery, Wrexham Maelor Hospital, Wrexham, UK
  6. 6 Department of Emergency Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
  7. 7 Division of Critical Care, University of Ottawa, Ottawa, Ontario, Canada
  8. 8 Faculty of Medicine, Queen's University, Kingston, Ontario, Canada
  9. 9 Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada
  10. 10 Department of Epidemiology, University of Ottawa, Ottawa, Ontario, Canada
  1. Correspondence to Dr Ross Prager, Department of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada; rprag011{at}


Objectives Systematic reviews are often considered among the highest quality of evidence. Completely reported systematic reviews, however, are required so readers can assess for generalisability of the research to practice and risk of bias. The objective of this study was to assess the completeness of reporting for systematic reviews assessing the diagnostic accuracy of point-of-care ultrasound (POCUS) using the Preferred Reporting Items for Systematic Reviews and Meta-analyses for Diagnostic Test Accuracy (PRISMA-DTA) checklist that was published in 2018.

Design and setting In this meta-research study, MEDLINE, EMBASE and Cochrane Library databases were searched, with no date restriction, on March 1st, 2020 for systematic reviews assessing the diagnostic accuracy of POCUS. Adherence to PRISMA-DTA for the main text and abstract was scored independently and in duplicate using a modified checklist. Prespecified subgroup analyses were performed.

Main outcome measures The primary outcome was the mean PRISMA-DTA checklist adherence for the full-text and abstract.

Results A total of 71 studies published from 2008 to 2020 met the inclusion criteria. The overall adherence for the full-text was moderate: 19.8 out of 26.0 items (76%) and for the abstract was 7.0 out of 11.0 items (64%). Although many items in the PRISMA-DTA checklist were frequently reported, several were r infrequently reported (<33% of studies), including item 5 (protocol registration), item D2 (minimally acceptable test accuracy) and item 14 (variability in target condition, index test and reference standards). Subgroup analyses showed a higher PRISMA-DTA mean adherence (SD) for high impact journals (20.9 (2.52) vs 18.9 (1.95); p<0.001), studies including supplemental materials (20.6 (2.48) vs 18.9 (2.28); p=0.004), studies citing adherence to PRISMA reporting guidelines (20.4 (1.95) vs 19.0 (3.00); p=0.038) and studies published in journals endorsing PRISMA guidelines (20.2 (2.47) vs 18.6 (2.37); p=0.025). There was variable adherence based on journal of publication (p=0.006), but not for study population (adult vs paediatric vs mixed) (p=0.62), year of publication (p=0.94), body region (p=0.78) or country (p=0.40). There was no variability in abstract adherence based on whether the abstract was structured with subheadings or not (p=0.25). A Spearman’s correlation found moderate correlation between higher word counts and abstractand full-text adherence (R=0.45, p<0.001 and R=0.38, p=0.001), respectively.

Conclusions Overall, the reporting of POCUS diagnostic accuracy systematic reviews and meta-analyses was moderate. We identified deficits in several key areas including the preregistration of systematic reviews in an online repository, handling of multiple definitions of target conditions, index tests and reference standards and specifying minimally acceptable test accuracy. Prospective registration of reviews and detailed reporting as per PRISMA-DTA during the research process could improve reporting completeness. At an editorial level, word count and supplemental material limitations may impede reporting completeness, whereas endorsement of reporting guidelines on journal websites could improve reporting.

  • radiology
  • emergency medicine

Data availability statement

Data are available on reasonable request from the corresponding author.

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Data availability statement

Data are available on reasonable request from the corresponding author.

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  • Contributors All authors contributed to the study design, interpretation and writing of the manuscript. MP and RP are co-first authors owing to their equal, substantial contributions to all aspects of the project.

  • Funding MDFM declares support from the University of Ottawa Department of Radiology Research Stipend Program. Grant number: not applicable.

  • Competing interests DJK is on the medical advisory board for the ultrasound company Clarius Mobile Health, however, has no relevant financial or other competing interests with respect to this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.