Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative

Objective To improve the accuracy and completeness of reporting of studies of diagnostic accuracy, to allow readers to assess the potential for bias in a study, and to evaluate a study's generalisability. Methods The Standards for Reporting of Diagnostic Accuracy (STARD) steering committee searched the literature to identify publications on the appropriate conduct and reporting of diagnostic studies and extracted potential items into an extensive list. Researchers, editors, and members of professional organisations shortened this list during a two day consensus meeting, with the goal of developing a checklist and a generic flow diagram for studies of diagnostic accuracy. Results The search for published guidelines about diagnostic research yielded 33 previously published checklists, from which we extracted a list of 75 potential items. At the consensus meeting, participants shortened the list to a 25 item checklist, by using evidence, whenever available. A prototype of a flow diagram provides information about the method of patient recruitment, the order of test execution, and the numbers of patients undergoing the test under evaluation and the reference standard, or both. Conclusions Evaluation of research depends on complete and accurate reporting. If medical journals adopt the STARD checklist and flow diagram, the quality of reporting of studies of diagnostic accuracy should improve to the advantage of clinicians, researchers, reviewers, journals, and the public.

The STARD statement for reporting studies of diagnostic accuracy: Explanation and elaboration

The quality of reporting of studies of diagnostic accuracy is less than optimal. Complete and accurate reporting is necessary to enable readers to assess the potential for bias in the study and to evaluate the generalisability of the results. A group of scientists and editors has developed the STARD (Standards for Reporting of Diagnostic Accuracy) statement to improve the reporting the quality of reporting of studies of diagnostic accuracy. The statement consists of a checklist of 25 items and flow diagram that authors can use to ensure that all relevant information is present. This explanatory document aims to facilitate the use, understanding and dissemination of the checklist. The document contains a clarification of the meaning, rationale and optimal use of each item on the checklist, as well as a short summary of the available evidence on bias and applicability. The STARD statement, checklist, flowchart and this explanation and elaboration document should be useful resources to improve reporting of diagnostic accuracy studies. Complete and informative reporting can only lead to better decisions in healthcare.

Measuring the success of wildlife rehabilitation: Koalas and Brushtail possums

Native mammal populations in Southeast Queensland are under threat from habitat loss through land development, dog attacks and motor vehicle accidents. Animals that are not killed from these impacts are sometimes rescued, rehabilitated and later released back into the wild, usually in their area of origin. Although the release of these animals is a relatively common practice, little post release monitoring has been carried out and reported to assess the success of the animals in the wild. This paper discusses the results of three recent studies which have monitored the movements and health of rehabilitated and translocated koalas (Phascolarctos ciniereus) and common brushtail possums (Trichosurus vulpecular): one conducted by Wildcare Australia in 1995- 1996, the other two in collaboration with the University of Queensland. The results indicate that the survival and health of the great majority of the released animals were good and that they were usually able to establish new home ranges during the tracking period. Such findings seem to contradict the results of studies conducted in southern Australia which have monitored the release of translocated possums and gliders, and suggest that there are some key factors which may be critical in determining the success of such releases. These factors include the age of admission and the duration of care, and in particular the selection of the release site. With both koalas and brushtail possums, the release site was found to be critical in determining both the survival and dispersal of the released animals. Consequently, while these studies confirm that the reintroduction of koalas and common brushtail possums may be a viable management strategy, the individual characteristics of the animals themselves and of their release areas must be carefully considered. It is recommended that further research of these key release factors be undertaken and that the work be extended for other species which are commonly released following rehabilitation.