• Adequately Reporting Biomedical Research Describing Consensus Methods: the ACCORD Guidelines

    Adequately Reporting Biomedical Research Describing Consensus Methods: the ACCORD Guidelines
    Adequately Reporting Biomedical Research Describing Consensus Methods: the ACCORD Guidelines

    In the dynamic landscape of evidence-based medicine, the ACCORD (ACcurate COnsensus Reporting Document) Reporting Guideline emerges as a transformative solution to the longstanding challenge of suboptimal reporting of the methods used in consensus statements in health research. Developed using a robust and systematic approach, ACCORD addresses the common need in biomedical research to achieve consensus among individuals with diverse perspectives, particularly in situations where evidence is emerging, inconsistent, limited, or absent. It serves as a comprehensive tool, providing a checklist for scientific publications reporting outcomes from a wide array of consensus methods. Whether in fast-paced pandemics or amid ample research evidence, ACCORD ensures rigorous and transparent reporting, enhancing the impact and reliability of consensus studies in healthcare decision-making.[1]

    Published first in 2024, the ACCORD checklist marks a pioneering step as the first universally applicable reporting guideline for consensus-based studies. This guideline serves as a valuable tool for authors, facilitating the creation of accurate and detailed manuscripts. By enhancing the completeness and transparency of reporting, it ensures that readers gain a clear understanding of the methodologies employed to reach a consensus. Importantly, the checklist emphasizes the rigor of consensus methods, thereby reinforcing the integrity of recommendations from consensus panels.[3,4]

    The development of ACCORD was marked by openness and collaboration, involving participants with diverse expertise, including methodologists, patient advocates, healthcare professionals, journal editors, and representatives from the pharmaceutical industry. The process began with a systematic review that identified common gaps in reporting consensus methods, leading to the formulation of a comprehensive checklist. The ACCORD checklist was not imposed as a mandate for study conduct but rather as a reporting guideline, aiming to enhance transparency and robustness in consensus studies. Stability of agreement, a key indicator of consensus among a group, was achieved by adhering to a simple definition. ACCORD considered consensus as reaching the apriori agreed threshold for agreement over a minimum of two voting rounds, ensuring a robust and stable foundation for the reporting guideline.[2]

    The ACCORD checklist for reporting consensus methods has compiled 36 crucial items organized under ten sections, that researchers should report when utilizing consensus methods in biomedical research. It meticulously guides them through every stage, starting with justifying the need for a consensus approach and defining the specific research questions. It further delves into the composition and selection process of the expert panel, ensuring diversity, relevant expertise, and transparency regarding potential conflicts of interest. The chosen consensus technique, how the agreement was measured, and the detailed process itself are also required to be reported, with an intention to reveal how data and evidence were integrated to reach recommendations. Finally, the checklist emphasizes reporting strengths, limitations, potential biases, and funding sources to foster complete transparency.[2]

    The ACCORD checklist stands as the inaugural reporting guideline universally applicable to all consensus-based studies. It aids authors in crafting precise and detailed manuscripts, elevating the completeness and transparency of reporting. By doing so, it offers readers clarity on the methodologies employed to attain agreement and highlights the rigor of consensus methods that underpin recommendations. The checklist’s implementation not only improves the overall reporting quality but also fosters trust in the recommendations put forth by consensus panels, reinforcing the integrity of consensus studies.[2]

    Despite the strengths of ACCORD, certain limitations have been acknowledged in the original publication. The diversity of the panel, both in terms of geography and professional backgrounds, fell short of the initial aspirations. Efforts to recruit a more diverse panel from different regions and professions, especially from South America, Asia, Africa, and Oceania, encountered challenges. The ACCORD Steering Committee recognized the importance of addressing these limitations in future revisions or extensions to ensure a more inclusive representation of expertise and experiences. Looking ahead, the ACCORD Reporting Guideline anticipates the need for updates and extensions. The rapidly evolving landscape of technology and consensus methods necessitates continuous refinement. Future updates may explore extensions into areas such as nonclinical biomedical studies, health economics, health informatics, and artificial intelligence.[2]

    In conclusion, the ACCORD Reporting Guideline stands as a milestone in promoting rigor and transparency in health-related research involving consensus methods. Its comprehensive checklist addresses the limitations of existing reporting guidelines, offering a versatile tool applicable to a myriad of consensus methods. The collaborative development process, though not without its challenges, reflects a commitment to inclusivity and transparency.

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    References

    1. Murphy MK, Black NA, Lamping DL, et al. Consensus development methods, and their use in clinical guideline development. Health Technol Assess. 1998;2(3):i-iv, 1-88.
    2. Gattrell WT, Logullo P, van Zuuren EJ, et al. ACCORD (ACcurate COnsensus Reporting Document): A reporting guideline for consensus methods in biomedicine developed via a modified Delphi. PLoS Med. 2024 Jan 23;21(1):e1004326.
    3. Brouwers MC, Kerkvliet K, Spithoff K; AGREE Next Steps Consortium. The AGREE Reporting Checklist: a tool to improve reporting of clinical practice guidelines. BMJ. 2016 Mar 8;352:i1152.
    4. Kirkham JJ, Gorst S, Altman DG, et al. Core Outcome Set-STAndards for Reporting: The COS-STAR Statement. PLoS Med. 2016 Oct 18;13(10):e1002148.
  • Reporting Systematic Review of Systematic Reviews: The Significance of PRIOR Statement

    Reporting Systematic Review of Systematic Reviews: The Significance of PRIOR Statement

    In healthcare research, evidence-based decision-making is essential, elevating systematic literature reviews (SLRs) as the go-to method. These reviews meticulously assess and consolidate research on specific topics, setting the standard for evidence-based practice. Yet, with the surge in SLRs, the need for effective methods to navigate and synthesize their outcomes became crucial. This gave rise to overviews of SLRs (also referred to as umbrella reviews, meta-reviews, or cumulative reviews), offering a comprehensive view by amalgamating findings from multiple SLRs.[1]

    Umbrella reviews offer a comprehensive understanding of the current state of knowledge on a specific topic by consolidating the findings from multiple SLRs. They help identify gaps, inconsistencies, and emerging trends in the research landscape. However, ensuring the quality and transparency of overviews is crucial for their reliable interpretation and application. Though the PRISMA statement and its various extensions already provide reporting guidelines for various types of SLRs, none of the PRISMA extensions currently cater exclusively to reporting overviews of SLRs. This led to the development of the Preferred Reporting Items for Overviews of Reviews (PRIOR) statement in 2022 to provide a comprehensive framework for reporting overviews of SLRs.[1, 2]

    The PRIOR statement includes a checklist with 27 main items organized into seven sections, namely Title, Abstract, Introduction, Methods, Results, Discussion, and Other Information, each prescribing a critical role in ensuring a comprehensive and transparent overview of systematic reviews. The PRIOR statement recommends that the title of the umbrella reviews must clearly identify the report as an overview of reviews, and the abstract must provide a comprehensive and accurate summary of the purpose, methods, and results of the overview. The introduction must contain the rationale behind conducting the overview, with explicitly stated objectives establishing the study’s context and goals.[3,4]

    The PRIOR statement emphasizes that the methods section of the umbrella review must meticulously cover eligibility criteria, information sources, selection processes, data collection process, and synthesis methods and provide a list of data items. The methods section must also contain the risk of bias assessment and reporting bias assessment, in addition to a certainty assessment. The results section should present exhaustive details, including systematic review characteristics, primary study overlap, risk of bias assessments, and synthesized findings, and also present the details of certainty of evidence. The discussion should critically interpret findings, highlight any discrepancies, discuss limitations, and explore implications for practice, policy, and future research. The “Other Information” section should address essential aspects such as registration, support, competing interests, author contributions, and the availability of data and materials, contributing to the overall integrity and accessibility of the umbrella review.[4]

    The PRIOR statement confers numerous benefits, serving as a crucial tool for robust reporting of umbrella reviews. By providing a standardized checklist, PRIOR ensures improved reporting quality, mitigating the risk of omitting crucial information and fostering consistency across diverse reviews. This not only enhances the overall transparency of research methodologies but also facilitates efficient replication of the review process, contributing to scientific rigor and allowing for timely updates based on emerging evidence. Moreover, PRIOR encourages the use of standardized data extraction forms and tables, streamlining the synthesis process across multiple reviews and resulting in more accurate and reliable conclusions. Ultimately, overviews adhering to PRIOR guidelines become powerful tools for informing evidence-based decision-making in clinical practice, policy formulation, and healthcare resource allocation, amplifying their impact on the healthcare landscape.[5]

    In its present iteration, the PRIOR statement helps in the reporting of umbrella reviews of healthcare interventions only and might not be suitable for other types of umbrella reviews (e.g., qualitative, diagnostic accuracy). Development of extensions to the PRIOR statement, similar to PRISMA extensions, might enhance the usability of the PRIOR statement to other types of reviews as well.[5]

    As evidence synthesis continues to play a pivotal role in healthcare decision-making, the need for standardized reporting has never been more crucial. PRIOR, with its meticulous development process, tailored approach for umbrella reviews, and emphasis on transparency, contributes significantly to the advancement of evidence-based clinical decision-making. Collaboration among researchers, authors, editors, and publishers is imperative to overcome existing challenges and refine the application of reporting guidelines in the dynamic field of healthcare research.

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    References

    1. Smith V, Devane D, Begley CM, Clarke M. Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC medical research methodology. 2011 Dec;11(1):1-6.
    2. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. International journal of surgery. 2021 Apr 1;88:105906.
    3. Pollock M, Fernandes RM, Pieper D, et al. Preferred Reporting Items for Overviews of Reviews (PRIOR): a protocol for development of a reporting guideline for overviews of reviews of healthcare interventions. Systematic reviews. 2019 Dec;8:1-9.
    4. Gates M, Gates A, Pieper D, et al. Reporting guideline for overviews of reviews of healthcare interventions: development of the PRIOR statement. BMJ. 2022 Aug 9;378:e070849.
    5. Yang N, Liu H, Zhang K, et al. Viewpoints on the PRIOR statement-a reporting guideline for overviews of reviews. Ann Transl Med. 2023 Mar 15;11(5):230.