Table 2.

Potential Benefits and Proposed Stakeholder Actions for Supporting Adherence to SPIRIT 2013

Stakeholder	Proposed Actions	Potential Benefits
Clinical trial groups, investigators, sponsors	Adopt SPIRIT as standard guidance Use as tool for writing protocols	Improved quality, completeness, and consistency of protocol content Enhanced understanding of rationale and issues to consider for key protocol items Increased efficiency of protocol review
Research ethics committees/institutional review boards, funding agencies, regulatory agencies	Mandate or encourage adherence to SPIRIT for submitted protocols Use as training tool	Improved quality, completeness, and consistency of protocol submissions Increased efficiency of review and reduction in queries about protocol requirements
Educators	Use SPIRIT checklist and explanatory paper as a training tool	Enhanced understanding of the rationale and issues to consider for key protocol items
Patients, trial participants, policymakers	Advocate use of SPIRIT by trial investigators and sponsors	Improved protocol content relevant to transparency, accountability, critical appraisal, and oversight
Trial registries	Encourage SPIRIT-based protocols Register full protocols to accompany results disclosure	Improved quality of registry records Prompt for trialists to update registry record when SPIRIT checklist item 2b (Registration Data Set) is updated Improved quality, completeness, and consistency of protocol content for registries that house full protocols and results
Journal editors and publishers	Endorse SPIRIT as standard guidance for published and unpublished protocols Include reference to SPIRIT in instructions for authors Ask that protocols be submitted with manuscripts, circulate them to peer reviewers, and encourage authors to make them available as Web appendices	Improved quality, completeness, and consistency of protocol content Enhanced peer review of trial manuscripts through improved protocol content, which can be used to assess protocol adherence and selective reporting Improved transparency and interpretation of trials by readers

SPIRIT = Standard Protocol Items: Recommendations for Interventional Trials.