Article Text

other Versions

Download PDFPDF
Emergency care
Barriers to reporting guideline adherence in point-of-care ultrasound research: a cross-sectional survey of authors and journal editors
  1. Ross Prager1,
  2. Luke Gagnon1,
  3. Joshua Bowdridge1,
  4. Rudy R Unni1,
  5. Trevor A McGrath2,
  6. Kelly Cobey3,4,
  7. Patrick M Bossuyt5,
  8. Matthew D F McInnes2,4
  1. 1Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
  2. 2Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada
  3. 3Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
  4. 4Department of Epidemiology, University of Ottawa, Ottawa, Ontario, Canada
  5. 5Department of Epidemiology and Data Science, Amsterdam University Medical Centres, Duivendrecht, North Holland, The Netherlands
  1. Correspondence to Dr Ross Prager, Department of Medicine, University of Ottawa, Ottawa, Canada; rprag011{at}


Objective Although the literature supporting the use of point-of-care ultrasound (POCUS) continues to grow, incomplete reporting of primary diagnostic accuracy studies has previously been identified as a barrier to translating research into practice and to performing unbiased systematic reviews. This study assesses POCUS investigator and journal editor attitudes towards barriers to adhering to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015 guidelines.

Design, setting, participants Two separate surveys using a 5-point Likert scale were sent to POCUS study investigators and journal editors to assess for knowledge, attitude and behavioural barriers to the complete reporting of POCUS research. Respondents were identified based on a previous study assessing STARD 2015 adherence for POCUS studies published in emergency medicine, anaesthesia and critical care journals. Responses were anonymously linked to STARD 2015 adherence data from the previous study. Written responses were thematically grouped into the following categories: knowledge, attitude and behavioural barriers to quality reporting, or other. Likert response items are reported as median with IQRs.

Main outcome measures The primary outcome was the median Likert score for the investigator and editor surveys assessing knowledge, attitude and behavioural beliefs about barriers to adhering to the STARD 2015 guidelines.

Results The investigator survey response rate was 18/69 (26%) and the editor response rate was 5/21 (24%). Most investigator respondents were emergency medicine practitioners (13/21, 62%). Two-thirds of investigators were aware of the STARD 2015 guidelines (12/18, 67%) and overall agreed that incomplete reporting limits generalisability and the ability to detect risk of bias (median 4 (4, 5)). Investigators felt that the STARD 2015 guidelines were useful, easy to find and easy to use (median 4 (4, 4.25); median 4 (4, 4.25) and median 4 (3, 4), respectively). There was a shared opinion held by investigators and editors that the peer review process be primarily responsible for ensuring complete research reporting (median 4 (3, 4) and median 4 (3.75, 4), respectively). Three of 18 authors (17%) felt that the English publication language of STARD 2015 was a barrier to adherence.

Conclusions Although investigators and editors recognise the importance of completely reported research, reporting quality is still a core issue for POCUS research. The shared opinion held by investigators and editors that the peer review process be primarily responsible for reporting quality is potentially problematic; we view completely reported research as an integral part of the research process that investigators are responsible for, with the peer review process serving as another additional layer of quality control. Endorsement of reporting guidelines by journals, auditing reporting guideline adherence during the peer review process and translation of STARD 2015 guidelines into additional languages may improve reporting completeness for the acute POCUS literature.

Trial registration number Open Science Framework Registry (

  • evidence-based practice
  • critical care
  • radiology
  • emergency medicine

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors All authors contributed to the study design, data interpretation and manuscript writing. RP and MDFM take full responsibility for the completeness and integrity of the data. RP and LG are co-first authors due to equal and significant contributions to all aspects of the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study obtained research ethics approval from the Ottawa Health Science Network Research Ethics Board (20200054-01H).

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

  • Data availability statement Data are available upon reasonable request. Data are available by request from the corresponding author.

  • 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.