Do surgery journals insist on reporting by CONSORT and PRISMA? A follow-up survey of 'instructions to authors'.

AIMS: Guidance has been published on how best to report randomised controlled trials (Consolidated Standards of Reporting Trials - CONSORT) and systematic reviews (Preferred Reporting Items for Systematic Reviews and Meta-analysis - PRISMA). In 2011, we reported a low rate of enforcement by surgery journals for submitted manuscripts to conform to these guidelines. The aim of this follow-up study is to establish whether there has been any improvement. METHODS: We studied the 134 surgery journals indexed in the Journal Citation Report. The 'Instructions to Authors' were scrutinised for inclusion of the following guidance: CONSORT, PRISMA, clinical trial registration and systematic review registration. RESULTS: Compared to 2011, there has been an improvement in the endorsement of reporting guidance in journals' 'Instructions to Authors' in 2014, as follows: trial registration (42% vs 33%), CONSORT (42% vs 30%) and PRISMA (19% vs 10%, all p < 0.001). As in 2011, journals with a higher impact were more likely to adopt trial registration (p < 0.001), CONSORT (p < 0.001) and PRISMA (p = 0.002). Journals with editorial offices in the UK were more likely to endorse guidance compared to those outside the UK (p < 0.05). Only one journal mentioned registration for systematic reviews. CONCLUSIONS: Surgery journals are presently more likely to require submitted manuscripts to follow published reporting guidance compared to three years ago. However, overall concordance rates are still low, and an improvement is required to help enhance the quality of reporting - and ultimately the conduct - of randomised control trials and systematic reviews in surgery.

Endovascular aneurysm repair in nonagenarians: a systematic review.

BACKGROUND: Endovascular aortic aneurysm repair (EVAR) has been associated with a reduction in early morbidity and mortality compared with open surgery, creating an opportunity for aneurysm repair in those previously considered unfit for intervention. We determine the published incidence of complications and survival after elective EVAR in nonagenarians. METHODS: A systematic literature search was performed using the PubMed, EMBASE, and Cochrane databases up to December 2012. Two observers independently screened search results and extracted data. RESULTS: Six retrospective reports were identified including 361 patients (81% men) with a mean age of 91.6 years. The mean aneurysm size was 69 mm. Comorbidities include hypertension (81%), ischemic heart disease (50%), peripheral vascular disease (30%), and chronic obstructive pulmonary disease (20%). There was no intraoperative mortality, 22% of patients had perioperative medical or surgical complications, and 24% had endoleaks. Mean duration of hospital stay was 4 days. Thirty-day mortality was 5%, and survival at 1, 3, and 5 years was 82%, 56%, and 17%, respectively. CONCLUSIONS: Although the complication rates and longer term survival after elective EVAR in carefully selected nonagenarians appear acceptable, they are higher than those reported in younger patients. Given the typical life expectancy, careful consideration should be given to individual cases before undertaking EVAR in the nonagenarian.

The reporting quality of systematic reviews and meta-analyses in vascular surgery needs improvement: a systematic review.

INTRODUCTION: Systematic reviews and meta-analyses are important in shaping clinical practice, but the underlying quality of these studies is critical. The PRISMA guidelines for the reporting of systematic reviews, published in 2009, aimed to improve the quality of reporting of these studies. We looked at whether the reporting of systematic reviews relevant to vascular surgery had improved since the introduction of these guidelines. METHODS: All systematic reviews and meta-analyses published in the top five general and top five vascular surgery journals in the years 2008 (pre-PRIMSA) and 2012 (post-PRISMA) were included. We examined the proportion of concordance of each individual paper with the 27 PRISMA statements. RESULTS: A total of 74 studies were found (n = 37 in 2008, n = 37 in 2012), most of which were found in the specific vascular surgery journals. The average proportion of concordance of systematic reviews to the PRISMA guidance increased between 2008 and 2012 (from 65% to 73%, p < 0.01), indicating some improvement in reporting quality. DISCUSSION: Since the publication of the PRISMA guidance, there has been a marginal improvement in the quality of reporting of systematic reviews and meta-analyses in the field of vascular surgery. However, given the importance of these studies, this needs to be improved, especially as poor reporting may reflect poor methodology in conduct. Journals' instructions to authors should insist on submissions following the published guidance, and this intervention would likely improve both the methodology and quality of reporting of published systematic reviews.