Emergency Ultrasound Literature and Adherence to Standards for Reporting of Diagnostic Accuracy Criteria

J Emerg Med. 2020 Apr;58(4):636-646. doi: 10.1016/j.jemermed.2019.09.029. Epub 2019 Nov 7.


Background: Given the wide usage of emergency point-of-care ultrasound (EUS) among emergency physicians (EPs), rigorous study surrounding its accuracy is essential. The Standards for Reporting of Diagnostic Accuracy (STARD) criteria were established to ensure robust reporting methodology for diagnostic studies. Adherence to the STARD criteria among EUS diagnostic studies has yet to be reported.

Objectives: Our objective was to evaluate a body of EUS literature shortly after STARD publication for its baseline adherence to the STARD criteria.

Methods: EUS studies in 5 emergency medicine journals from 2005-2010 were evaluated for their adherence to the STARD criteria. Manuscripts were selected for inclusion if they reported original research and described the use of 1 of 10 diagnostic ultrasound modalities designated as "core emergency ultrasound applications" in the 2008 American College of Emergency Physicians Ultrasound Guidelines. Literature search identified 307 studies; of these, 45 met inclusion criteria for review.

Results: The median STARD score was 15 (interquartile range [IQR] 12-17), representing 60% of the 25 total STARD criteria. The median STARD score among articles that reported diagnostic accuracy was significantly higher than those that did not report accuracy (17 [IQR 15-19] vs. 11 [IQR 9-13], respectively; p < 0.0001). Seventy-one percent of articles met ≥50% of the STARD criteria (56-84%) and 4% met >80% of the STARD criteria.

Conclusions: Significant opportunities exist to improve methodological reporting of EUS research. Increased adherence to the STARD criteria among diagnostic EUS studies will improve reporting and improve our ability to compare outcomes.

Keywords: STARD; diagnostic accuracy; emergency medicine; point-of-care ultrasound; research methodology; standards for the reporting of diagnostic accuracy.