EQUATOR: reporting guidelines for health research

Despite the effort of researchers, editors and peer reviewers, the quality of health-research reporting in journal articles is unsatisfactory.^1-6 Guidelines that specify a minimum set of items for reporting can improve the accuracy and transparency of publications, thus facilitating easier and more reliable appraisal of quality and relevance. During the past 10 years several internationally respected guidelines for the reporting of health research have been developed.^7-10 However, those guidelines are still not widely supported by medical journals^{11, 12} or adhered to by researchers, and thus their potential impact is lessened.

To remedy this situation the UK National Knowledge Service provided funding to start the EQUATOR project (Enhancing the QUAlity and Transparency Of health Research). This initiative seeks to improve the reliability of medical publications by promoting transparent and accurate reporting of health research. This movement grew out of the work of CONSORT⁹ and other groups.

EQUATOR is an umbrella for all areas of health-research reporting. The network aims to become a global centre that provides resources and training, and which assists in the development, dissemination, and implementation of robust reporting guidelines. EQUATOR's strategic plan reflects the needs of its major stakeholders: developers of reporting guidelines, researchers, journal editors, peer-reviewers, and research-funding bodies.

One of the first activities was to identify existing reporting guidelines to see how they were developed. The development methods of most guidelines were broadly similar, but with wide variation in important details. Development usually took a long time and only half the groups had strategies for dissemination and implementation of their guidelines. The difficulty of securing sufficient funding to develop, assess, and disseminate guidelines was widely acknowledged as a major problem.

The initial survey and discussions with the main stakeholders helped us to prioritise future activities. First, we developed an internet-based resource centre, which can be freely accessed on our website.¹³ At present, it provides a collection of available reporting guidelines. In the future, the website will also host other resources for authors of research articles, editors, peer-reviewers, and developers of guidelines, including a comprehensive digital library for health-research reporting, guidance for the development of robust reporting guidelines, tools to facilitate their use, and educational materials.

The availability of good reporting guidelines is not sufficient for the improvement of the quality of reporting. Our second priority will be active promotion of such guidelines and their use, by developing and running training for editors, peer-reviewers, and authors. The courses will concentrate on the important factors of research reporting and the efficient use of reporting guidelines.

Figure 1.

EQUATOR Network logo

Poor reporting reflects a collective failure of those involved. Collaboration with and the support of influential medical journals are vital for the success of this project. Benefits will be equally split between both communities—users will benefit from improved reliability of scientific information and journals will benefit from increased loyalty of their readers attracted by improved accuracy and reliability of reports. The EQUATOR network will regularly monitor how journals implement reporting guidelines. We will annually audit the quality of reporting across the health-research literature and hope to document gradual improvements.

Sufficient funding is a necessary requirement for the development and implementation of robust reporting guidelines and widespread promotion of good reporting of research. In view of how much money funding agencies spend on health research, their lack of interest in ensuring that this research is reported accurately is deeply disappointing. Good reporting is not an optional extra; it is an essential component of research. Funding bodies should recognise this and support initiatives such as EQUATOR that aim to improve the current situation.

The EQUATOR Network will hold its official launch meeting on June 26, 2008, in London, UK. The meeting will focus on better understanding of problems associated with health-research reporting and use of reporting guidelines, and on finding potential solutions to improve the health-research literature.

Biographies

Douglas Altman is professor of Statistics in Medicine at the Institute of Health Sciences in the University of Oxford in Oxford, UK.

Iveta Simera is senior project manager of the EQUATOR Network at the Centre for Statistics in Medicine in the University of Oxford in Oxford, UK.

John Hoey is professor of medicine at Queen's University is Kingston, Ontario.

David Moher is at the Chalmers Research Group at the University of Ottawa in Ottawa, Ontario.

Ken Schulz is vice president of Quantitative Sciences at Family Health International in Durham, NC.