Discussion

In this exploratory study, we found that reporting guidelines were used in only a few (1 in 15) infectious diseases research manuscripts published during 2019 in five selected, quartile 1 infectious diseases journals. Low use rates were observed even in clinical trials (CONSORT) and animal research studies (ARRIVE), study designs that are typically subject to stricter regulations. This finding seems contradictory, considering that these guidelines are intended to help authors clearly communicate all the relevant information that a scientific report is expected to contain. Additionally, these guidelines are free for use, easily accessible, and customized to each study design; most journals and publishers endorse them, albeit to varying degrees.

We do not know the reasons for the infrequent use of reporting guidelines. It is unlikely that our findings were owing to errors in the assessment because the acronyms or full names of the guidelines would have appeared in the article text and/or reference list if they had been used. Alternatively, reporting guidelines may have been used but not mentioned by the authors of the published articles. However, this seems implausible because reporting that a guideline was followed increases the perceived robustness of the manuscript during peer review, so it is unlikely that authors would intentionally omit this information. Authors’ low awareness about reporting guidelines may be involved, but this is unlikely; CONSORT has been available for roughly 25 years, and most journals request this checklist to be followed when reporting clinical trials. Additionally, the EQUATOR network has been in operation for nearly 15 years, ^{5,Reference Begg, Cho and Eastwood14} and three of the five journals we assessed clearly endorse its use in their instructions for authors’ section. Indeed, even after extensive distribution of the PRISMA statement in co-publications in multiple major medical journals during 2009, ¹⁵ as well as the endorsement by major journals to use this guideline, we found that PRISMA and MOOSE guidelines for systematic reviews and meta-analyses were used in approximately half of the articles for which its use was advisable.

We are the first to assess the use of reporting guidelines in infectious diseases-focused journals, although a 2016 editorial published in the Journal of Infection Prevention endorses the use of reporting guidelines of the EQUATOR network and explains the rationale behind its decision ^{Reference Stone and Cookson6} . Research in other medical fields also shows low use of reporting guidelines. In seven public health journals, only 1.5% of articles published between 2010 and 2013 included the acronyms CONSORT, PRISMA, or STROBE. ^{Reference Mannocci, Saulle and Colamesta16} A study in the field of urogynecology described that the CONSORT, PRISMA, and STROBE guidelines were explicitly mentioned in only 25% of clinical trials, 54% of systematic reviews, and 1.2% of observational studies, respectively. ^{Reference Koch, Riss, Umek and Hanzal17} In a recent rheumatology study, ^{Reference Barajas-Ochoa, Cisneros-Barrios, Ramirez-Trejo and Ramos-Remus12} our group found that reporting guidelines were used in 5.6% of total articles or in 7.2% (95% CI: 5% to 9%) of articles for which guidelines were advisable. Whereas differences between these findings and our results may be attributable to different methods and time-related effects, our conclusions are similar: reporting guidelines have been and continue to be infrequently used.

One characteristic that strengthens our study is the assessment of “advisability” for using a reporting guideline in each assessed manuscript. This study dimension provided a context for the number of manuscripts in which guidelines were actually used and the specific guidelines used. Nevertheless, our study has limitations that must be considered. First, although we included all 2019 original research publications from five selected infectious diseases journals, our sample does not represent the whole universe of infectious diseases journals and does not include noninfectious diseases-focused journals that publish research associated with the field. Second, the study’s exploratory, cross-sectional design, and low values obtained for the studied variables preclude causality assumptions or inferences. Third, the “advisable use” designation was assigned by a single individual with experience in bibliometrics by following a previously used but not validated method ^{Reference Barajas-Ochoa, Cisneros-Barrios, Ramirez-Trejo and Ramos-Remus12} ; consequently, the possibility to over- or underestimate the advisable use is implicit. Despite this, our findings on reporting guideline use are consistent with those of other related publications. Fourth, we did not assess the degree to which manuscripts adhered to the reporting guideline recommendations when a reporting guideline was used; this assessment was beyond the scope of this study. However, several publications show that adherence to guidelines such as PRISMA and CONSORT has not been optimal in diverse areas, including rheumatology, ^{Reference Barajas-Ochoa, Cisneros-Barrios, Ramirez-Trejo and Ramos-Remus12} cardiovascular medicine, ^{Reference Sims, Bowers, Fernan, Dormire, Herrington and Vassar18} pediatric urology, ^{Reference McGrath, Chen, Braga and Farrokhyar19} occupational health, ^{Reference Tikka, Verbeek and Ijaz20} obstetrics, ^{Reference Doulaveris, Vani, Saccone, Chauhan and Berghella21} anesthesiology, ^{Reference Elliott, Coulman, Blencowe, Qureshi, Lee, Hinchliffe and Mouton22} emergency medicine, ^{Reference Nawijn, Ham, Houwert, Groenwold, Hietbrink and Smeeing23} internal medicine, ^{Reference McErlean, Samways, Godolphin and Chen24} head and neck cancer, ^{Reference Canagarajah, Porter, Mitra and Chu25} and otorhinolaryngology. ^{Reference Peters, Hooft, Grolman and Stegeman26} Finally, readers should be aware that the use of these reporting guidelines should not necessarily be equated to a high-quality presentation of study findings, but to ensuring the manuscript contains the necessary elements to properly evaluate the scientific endeavor and enhance reproducibility in science.

In summary, despite journal endorsement of their use, their free and easily accessible nature, and their potential benefits when used, reporting guidelines were used infrequently in research manuscripts published in five high-impact infectious diseases journals in this study. Although we cannot clarify the reasons behind this finding, our exploratory study is a starting point for future studies investigating issues such as whether authors are aware of existing guidelines, authors’ perception of the usefulness of known guidelines, and whether editors and publishers value existing guidelines. Further studies may also explore whether the use of reporting guidelines facilitates and save costs in the peer review process, which has been estimated to be 100 million hours in 2020 with an estimated monetary value of more than 1.5 billion USD based on time spent by reviewers in the United States, ^{Reference Aczel, Szaszi and Holcombe27} as well as whether the probability of manuscript acceptance increases with guideline use. We agree with the objective of the EQUATOR network, which is “to improve the reliability and value of published health research literature by promoting transparent and accurate reporting,” ⁵ and we believe that the use of reporting guidelines can help in achieving that goal.