The quality of reporting of diagnostic accuracy studies in pelvic floor transperineal three-dimensional ultrasound: a systematic review

INTRODUCTION: In recent years, a large number of studies have been published on the clinical relevance of pelvic floor three-dimensional (3D) transperineal ultrasound. Several studies compare ultrasonography to other imaging modalities or clinical examination. The quality of reporting these studies is not known.

OBJECTIVE/PURPOSE: To determine the compliance of diagnostic accuracy studies investigating pelvic floor 3D ultrasound, with Standards for Reporting of Diagnostic Accuracy (STARD) guidelines by means of a systematic review.

METHOD: This study reviewed published articles on pelvic floor 3D ultrasound identified by means of a systematic literature search that included the MEDLINE, Web of Science and SCOPUS databases. Prospective and retrospective studies that compared pelvic floor 3D ultrasound with other clinical and imaging diagnostics were included in the analysis. STARD compliance was assessed and quantified by two independent investigators, using 22 of the original 25 STARD checklist items. Items with the qualifier "if done" (items 13, 23 and 24) were excluded because they were not applicable to all papers. Each item was scored as reported (score = 1) or not reported (score = 0). We calculated observer variability, the total number of reported STARD items per article and summary scores for each item. We also statistically tested the difference in total score between STARD adopting and non-adopting journals, as well as the effect of year of publication.

RESULTS: Forty studies published in 13 scientific journals were included in the analysis. The mean score (SD) of articles included was 16.0 (2.5) out of a maximum of 22 points. The lowest scores, below 55%, were found on quality of reporting on handling of indeterminate results or missing responses, adverse events and time interval between tests. Interobserver rating agreement of STARD items was substantial (ICC 0.77). The independent t-test showed no significant mean differences (±SD) in total score between the adopting 15.9 (±2.6) and non-adopting 16.1 (± 2.5) journals. The mean STARD score for the period 2003-2009 (15.2 ± 2.5) was lower, but not statistically significant different as compared to the period 2010-2015 (16.6 ± 2.4).

CONCLUSION: The overall compliance with reporting guidelines of diagnostic accuracy studies of pelvic floor 3D transperineal ultrasound is relatively good, compared to other fields. However specific items should require more attention when reported.