“But WHAT did they actually do?”
Poor reporting of interventions: a remediable barrier
to research translation
Associate Professor Tammy Hoffmann
@Tammy_Hoffmann
thoffmann@bond.edu.au
Waste in Research
>85% of research is wasted due to:
Chalmers, I. & Glasziou, P., 2009. Avoidable waste in the production and reporting of research
evidence. Lancet, 374(9683), pp.86–9.
Reporting guidelines
• Although ultimate responsibility lies with researchers,
editors “should take all reasonable steps to ensure the
quality of the material they publish”.
• Guidelines for reporting health research are important
tools to facilitate this.
Reporting Guidelines
• Specify a minimum set of items needed for a
complete and clear account of study methods and
funding.
• Adherence to guidelines improves the accuracy and
transparency of publications.
• Some journals refer authors to guidelines in
‘Instructions to Authors’ – has much less impact on
reporting quality than requiring authors to adhere to
them
EQUATOR Network
www.equator-network.org/
A guide for promoting the use of reporting guidelines in your
journal:
http://www.equator-network.org/wpcontent/uploads/2012/12/Reporting-guidelines-in-journals-August2013.pdf
Most frequently used guidelines
• CONSORT – for reporting of randomised controlled
trials (RCTs)
- currently >23 000 trials in PEDro
• PRISMA – for systematic reviews and meta-analyses
• STARD – for diagnostic accuracy studies
• STROBE – for observational studies in epidemiology
Without a complete description of an
intervention…
• other researchers cannot replicate or build on research
findings
• for effective interventions, clinicians, patients, and other
decision makers are left unclear about how to reliably
implement the intervention
Do journals provide sufficient instructions to
authors?
• Audit of ‘Instructions to Authors’ for 106 journals
• 58% mentioned the CONSORT statement + 6% also mentioned the
CONSORT extension statements
• Only 15 (14%) specifically mentioned the reporting of interventions
Of these, nearly all provided non-specific instructions
e.g. “Describe study procedures, including any interventions…”
Hoffmann, T.C., English, T. & Glasziou Paul, P., 2014. Reporting of interventions in randomised
controlled trials: an audit of journal Instructions to Authors. Trials, 15(20).
How big is the problem?
% of interventions rated as
adequately described
100
90
80
After author contact
Initially
70
60
50
40
30
20
10
0
Setting
Recipient
Provider
Procedure Materials
Intensity
Schedule
Individual checklist items and overall rating of completeness of the
intervention description
Hoffmann, T., Erueti, C., & Glasziou, P. (2013). BMJ. 347:f3755
Overall
Aim of TIDieR
To improve the completeness
of reporting, and ultimately the
replicability, of interventions
 emphasis is on trials, but the guidance is intended to apply
across all evaluative study designs
http://www.bmj.com/content/348/bmj.g1687.long
TIDieR development process
• Literature review
Potential checklist items were generated from:
– Existing checklists
– Forward and backward citation searching of each
published checklist
– Research analysing the quality of intervention reporting in
trials and related literature
• Two round modified Delphi consensus survey
• Face-to-face consensus meeting
A recipe
CONSORT + TIDieR
• An extension of the CONSORT 2010 Statement:
SPIRIT + TIDieR
• An extension of:
Online supplementary materials
Published PROTOCOL
WEBSITE
Smartphone APP
VIDEO of the procedure
PHOTOS of materials
Limits?
Who should use TIDieR?
Authors
•
•
•
•
of trials
of protocols
of other evaluative study designs
of systematic reviews
Reviewers
Editors and Journals
- endorse TIDieR
- modify their ‘Instructions to Authors’ and require its use
(by authors AND reviewers)
BMJ 2014;348:g1687
www.equator-network.org/reporting-guidelines/tidier/
Checklist available in PDF and Word template