1
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Chan AW, Boutron I, Hopewell S, Moher D, Schulz KF, Collins GS, Tunn R, Aggarwal R, Berkwits M, Berlin JA, Bhandari N, Butcher NJ, Campbell MK, Chidebe RCW, Elbourne DR, Farmer AJ, Fergusson DA, Golub RM, Goodman SN, Hoffmann TC, Ioannidis JPA, Kahan BC, Knowles RL, Lamb SE, Lewis S, Loder E, Offringa M, Ravaud P, Richards DP, Rockhold FW, Schriger DL, Siegfried NL, Staniszewska S, Taylor RS, Thabane L, Torgerson DJ, Vohra S, White IR, Hróbjartsson A. SPIRIT 2025 statement: updated guideline for protocols of randomized trials. Nat Med 2025:10.1038/s41591-025-03668-w. [PMID: 40295741 DOI: 10.1038/s41591-025-03668-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2025] [Accepted: 03/20/2025] [Indexed: 04/30/2025]
Abstract
The protocol of a randomized trial is the foundation for study planning, conduct, reporting and external review. However, trial protocols vary in their completeness and often do not address key elements of design and conduct. The SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement was first published in 2013 as guidance to improve the completeness of trial protocols. Periodic updates incorporating the latest evidence and best practices are needed to ensure that the guidance remains relevant to users. Here, we aimed to systematically update the SPIRIT recommendations for minimum items to address in the protocol of a randomized trial. We completed a scoping review and developed a project-specific database of empirical and theoretical evidence to generate a list of potential changes to the SPIRIT 2013 checklist. The list was enriched with recommendations provided by lead authors of existing SPIRIT/CONSORT (Consolidated Standards of Reporting Trials) extensions (Harms, Outcomes, Non-pharmacological Treatment) and other reporting guidelines (TIDieR). The potential modifications were rated in a three-round Delphi survey followed by a consensus meeting. Overall, 317 individuals participated in the Delphi consensus process and 30 experts attended the consensus meeting. The process led to the addition of two new protocol items, revision to five items, deletion/merger of five items, and integration of key items from other relevant reporting guidelines. Notable changes include a new open science section, additional emphasis on the assessment of harms and description of interventions and comparators, and a new item on how patients and the public will be involved in trial design, conduct and reporting. The updated SPIRIT 2025 statement consists of an evidence-based checklist of 34 minimum items to address in a trial protocol, along with a diagram illustrating the schedule of enrollment, interventions and assessments for trial participants. To facilitate implementation, we also developed an expanded version of the SPIRIT 2025 checklist and an accompanying explanation and elaboration document. Widespread endorsement and adherence to the updated SPIRIT 2025 statement have the potential to enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, funders, research ethics committees, journals, trial registries, policymakers, regulators and other reviewers.
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Affiliation(s)
- An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada.
| | - Isabelle Boutron
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France
- Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, AP-HP, Paris, France
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Programme, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kenneth F Schulz
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gary S Collins
- UK EQUATOR Centre, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Ruth Tunn
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Rakesh Aggarwal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Michael Berkwits
- Office of Science Dissemination, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jesse A Berlin
- Department of Biostatistics and Epidemiology, School of Public Health, Center for Pharmacoepidemiology and Treatment Science, Rutgers University, New Brunswick, NJ, USA
- JAMA Network Open, Chicago, IL, USA
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nancy J Butcher
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Marion K Campbell
- Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen, UK
| | - Runcie C W Chidebe
- Project PINK BLUE - Health & Psychological Trust Centre, Utako, Abuja, Nigeria
- Department of Sociology and Gerontology, Miami University, Oxford, OH, USA
| | - Diana R Elbourne
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew J Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Robert M Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Steven N Goodman
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - Brennan C Kahan
- MRC Clinical Trials Unit at University College London, London, UK
| | - Rachel L Knowles
- University College London, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sarah E Lamb
- NIHR Exeter Biomedical Research Centre, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Steff Lewis
- Edinburgh Clinical Trials Unit, Usher Institute-University of Edinburgh, Edinburgh, UK
| | - Elizabeth Loder
- The BMJ, BMA House, London, UK
- Harvard Medical School, Boston, MA, USA
| | - Martin Offringa
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Philippe Ravaud
- Université Paris Cité, Inserm, INRAE, Centre de Recherche Epidémiologie et Statistiques, Université Paris Cité, Paris, France
| | - Dawn P Richards
- Clinical Trials Ontario, MaRS Centre, Toronto, Ontario, Canada
| | - Frank W Rockhold
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | - David L Schriger
- Department of Emergency Medicine, University of California, Los Angeles, CA, USA
| | | | - Sophie Staniszewska
- Warwick Applied Health, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Lehana Thabane
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - David J Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Sunita Vohra
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ian R White
- MRC Clinical Trials Unit at University College London, London, UK
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
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2
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Chan AW, Boutron I, Hopewell S, Moher D, Schulz KF, Collins GS, Tunn R, Aggarwal R, Berkwits M, Berlin JA, Bhandari N, Butcher NJ, Campbell MK, Chidebe RCW, Elbourne DR, Farmer AJ, Fergusson DA, Golub RM, Goodman SN, Hoffmann TC, Ioannidis JPA, Kahan BC, Knowles RL, Lamb SE, Lewis S, Loder E, Offringa M, Ravaud P, Richards DP, Rockhold FW, Schriger DL, Siegfried NL, Staniszewska S, Taylor RS, Thabane L, Torgerson DJ, Vohra S, White IR, Hróbjartsson A. SPIRIT 2025 Statement: Updated Guideline for Protocols of Randomized Trials. JAMA 2025:2833408. [PMID: 40294593 DOI: 10.1001/jama.2025.4486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2025]
Abstract
Importance The protocol of a randomized trial is the foundation for study planning, conduct, reporting, and external review. However, trial protocols vary in their completeness and often do not address key elements of design and conduct. The SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement was first published in 2013 as guidance to improve the completeness of trial protocols. Periodic updates incorporating the latest evidence and best practices are needed to ensure that the guidance remains relevant to users. Herein, we systematically update the SPIRIT recommendations for minimum items to address in the protocol of a randomized trial. Observations We completed a scoping review and developed a project specific database of empirical and theoretical evidence to generate a list of potential changes to the SPIRIT 2013 checklist. The list was enriched with recommendations provided by lead authors of existing SPIRIT/CONSORT (Consolidated Standards of Reporting Trials) extensions (harms, outcomes, nonpharmacological treatment) and other reporting guidelines (Template for Intervention Description and Replication [TIDieR]). The potential modifications were rated in a 3-round Delphi survey followed by a consensus meeting. Overall, 317 individuals participated in the Delphi consensus process and 30 experts attended the consensus meeting. The process led to the addition of 2 new protocol items, revision to 5 items, deletion/merger of 5 items, and integration of key items from other relevant reporting guidelines. Notable changes include a new open-science section, additional emphasis on the assessment of harms and description of interventions and comparators, and a new item on how patients and the public will be involved in trial design, conduct, and reporting. The updated SPIRIT 2025 statement consists of an evidence based checklist of 34 minimum items to address in a trial protocol, along with a diagram illustrating the schedule of enrollment, interventions, and assessments for trial participants. To facilitate implementation, we also developed an expanded version of the SPIRIT 2025 checklist and an accompanying explanation and elaboration document. Conclusions and Relevance Widespread endorsement and adherence to the updated SPIRIT 2025 statement have the potential to enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, funders, research ethics committees, journals, trial registries, policy makers, regulators, and other reviewers.
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Affiliation(s)
- An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Isabelle Boutron
- Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Paris, France
- Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, AP-HP, Paris, France
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Programme, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kenneth F Schulz
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill
| | - Gary S Collins
- United Kingdom EQUATOR Centre, Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
| | - Ruth Tunn
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
| | - Rakesh Aggarwal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Michael Berkwits
- Office of Science Dissemination, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jesse A Berlin
- Center for Pharmacoepidemiology and Treatment Science, Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, New Brunswick, New Jersey
- JAMA Network Open , Chicago, Illinois
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nancy J Butcher
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Marion K Campbell
- Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen, United Kingdom
| | - Runcie C W Chidebe
- Project PINK BLUE - Health & Psychological Trust Centre, Utako, Abuja, Nigeria
- Department of Sociology and Gerontology, Miami University, Ohio
| | - Diana R Elbourne
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Andrew J Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Robert M Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Steven N Goodman
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, California
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - John P A Ioannidis
- Department of Medicine, Stanford University, Stanford, California
- Department of Epidemiology and Population Health, Stanford University, Stanford, California
- Department of Biomedical Data Science, Stanford University, Stanford, California
- Department of Statistics, Stanford University, Stanford, California
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California
| | - Brennan C Kahan
- MRC Clinical Trials Unit, University College London, London, United Kingdom
| | - Rachel L Knowles
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - Sarah E Lamb
- NIHR Exeter Biomedical Research Centre, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Steff Lewis
- Edinburgh Clinical Trials Unit, Usher Institute-University of Edinburgh, Edinburgh BioQuarter, Edinburgh, United Kingdom
| | - Elizabeth Loder
- The BMJ , BMA House, London, United Kingdom
- Harvard Medical School, Boston, Massachusetts
| | - Martin Offringa
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Philippe Ravaud
- Centre de Recherche Epidémiologie et Statistiques, Université Paris Cité, Inserm, INRAE, Paris, France
| | - Dawn P Richards
- Clinical Trials Ontario, MaRS Centre, Toronto, Ontario, Canada
| | - Frank W Rockhold
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - David L Schriger
- Department of Emergency Medicine, University of California, Los Angeles
| | | | - Sophie Staniszewska
- Warwick Applied Health, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit and Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Lehana Thabane
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - David J Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, United Kingdom
| | - Sunita Vohra
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ian R White
- MRC Clinical Trials Unit, University College London, London, United Kingdom
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
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3
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Chan AW, Boutron I, Hopewell S, Moher D, Schulz KF, Collins GS, Tunn R, Aggarwal R, Berkwits M, Berlin JA, Bhandari N, Butcher NJ, Campbell MK, Chidebe RCW, Elbourne DR, Farmer AJ, Fergusson DA, Golub RM, Goodman SN, Hoffmann TC, Ioannidis JPA, Kahan BC, Knowles RL, Lamb SE, Lewis S, Loder E, Offringa M, Ravaud P, Richards DP, Rockhold FW, Schriger DL, Siegfried NL, Staniszewska S, Taylor RS, Thabane L, Torgerson DJ, Vohra S, White IR, Hróbjartsson A. SPIRIT 2025 statement: updated guideline for protocols of randomised trials. BMJ 2025; 389:e081477. [PMID: 40294953 PMCID: PMC12035670 DOI: 10.1136/bmj-2024-081477] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/31/2025] [Indexed: 04/30/2025]
Abstract
IMPORTANCE The protocol of a randomised trial is the foundation for study planning, conduct, reporting, and external review. However, trial protocols vary in their completeness and often do not address key elements of design and conduct. The SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement was first published in 2013 as guidance to improve the completeness of trial protocols. Periodic updates incorporating the latest evidence and best practices are needed to ensure that the guidance remains relevant to users. OBJECTIVE To systematically update the SPIRIT recommendations for minimum items to address in the protocol of a randomised trial. DESIGN We completed a scoping review and developed a project specific database of empirical and theoretical evidence to generate a list of potential changes to the SPIRIT 2013 checklist. The list was enriched with recommendations provided by lead authors of existing SPIRIT/CONSORT (Consolidated Standards of Reporting Trials) extensions (Harms, Outcomes, Non-pharmacological Treatment) and other reporting guidelines (TIDieR). The potential modifications were rated in a three-round Delphi survey followed by a consensus meeting. FINDINGS Overall, 317 individuals participated in the Delphi consensus process and 30 experts attended the consensus meeting. The process led to the addition of two new protocol items, revision to five items, deletion/merger of five items, and integration of key items from other relevant reporting guidelines. Notable changes include a new open science section, additional emphasis on the assessment of harms and description of interventions and comparators, and a new item on how patients and the public will be involved in trial design, conduct, and reporting. The updated SPIRIT 2025 statement consists of an evidence based checklist of 34 minimum items to address in a trial protocol, along with a diagram illustrating the schedule of enrolment, interventions, and assessments for trial participants. To facilitate implementation, we also developed an expanded version of the SPIRIT 2025 checklist and an accompanying explanation and elaboration document. CONCLUSIONS AND RELEVANCE Widespread endorsement and adherence to the updated SPIRIT 2025 statement have the potential to enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, funders, research ethics committees, journals, trial registries, policymakers, regulators, and other reviewers.
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Affiliation(s)
- An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, ON, M5S 1B2, Canada
| | - Isabelle Boutron
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France
- Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, AP-HP, Paris, France
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Programme, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Kenneth F Schulz
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gary S Collins
- UK EQUATOR Centre, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Ruth Tunn
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Rakesh Aggarwal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Michael Berkwits
- Office of Science Dissemination, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jesse A Berlin
- Department of Biostatistics and Epidemiology, School of Public Health, Center for Pharmacoepidemiology and Treatment Science, Rutgers University, New Brunswick, NJ, USA
- JAMA Network Open, Chicago, IL, USA
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nancy J Butcher
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Marion K Campbell
- Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen, UK
| | - Runcie C W Chidebe
- Project PINK BLUE - Health & Psychological Trust Centre, Utako, Abuja, Nigeria
- Department of Sociology and Gerontology, Miami University, OH, USA
| | - Diana R Elbourne
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew J Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Robert M Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Steven N Goodman
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, University Drive, Robina, QLD, Australia
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - Brennan C Kahan
- MRC Clinical Trials Unit at University College London, London, UK
| | - Rachel L Knowles
- University College London, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sarah E Lamb
- NIHR Exeter Biomedical Research Centre, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Steff Lewis
- Edinburgh Clinical Trials Unit, Usher Institute-University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK
| | - Elizabeth Loder
- The BMJ, BMA House, London, UK
- Harvard Medical School, Boston, MA, USA
| | - Martin Offringa
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Philippe Ravaud
- Université Paris Cité, Inserm, INRAE, Centre de Recherche Epidémiologie et Statistiques, Université Paris Cité, Paris, France
| | | | - Frank W Rockhold
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | - David L Schriger
- Department of Emergency Medicine, University of California, Los Angeles, CA, USA
| | | | - Sophie Staniszewska
- Warwick Applied Health, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Lehana Thabane
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, ON, Canada
- St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - David J Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Sunita Vohra
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ian R White
- MRC Clinical Trials Unit at University College London, London, UK
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
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4
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Hróbjartsson A, Boutron I, Hopewell S, Moher D, Schulz KF, Collins GS, Tunn R, Aggarwal R, Berkwits M, Berlin JA, Bhandari N, Butcher NJ, Campbell MK, Chidebe RCW, Elbourne DR, Farmer AJ, Fergusson DA, Golub RM, Goodman SN, Hoffmann TC, Ioannidis JPA, Kahan BC, Knowles RL, Lamb SE, Lewis S, Loder E, Offringa M, Ravaud P, Richards DP, Rockhold FW, Schriger DL, Siegfried NL, Staniszewska S, Taylor RS, Thabane L, Torgerson DJ, Vohra S, White IR, Chan AW. SPIRIT 2025 explanation and elaboration: updated guideline for protocols of randomised trials. BMJ 2025; 389:e081660. [PMID: 40294956 DOI: 10.1136/bmj-2024-081660] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2025]
Affiliation(s)
- Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Isabelle Boutron
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France
- Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, AP-HP, Paris, France
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Programme, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Kenneth F Schulz
- Department of Obstetrics and Gynaecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gary S Collins
- UK EQUATOR Centre, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Ruth Tunn
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Rakesh Aggarwal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | | | - Jesse A Berlin
- Department of Biostatistics and Epidemiology, School of Public Health, Centre for Pharmacoepidemiology and Treatment Science, Rutgers University, New Brunswick, NJ, USA
- JAMA Network Open, Chicago, IL, USA
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nancy J Butcher
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Marion K Campbell
- Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen, UK
| | - Runcie C W Chidebe
- Project PINK BLUE-Health and Psychological Trust Centre, Utako, Abuja, Nigeria
- Department of Sociology and Gerontology and Scripps Gerontology Centre, Miami University, OH, USA
| | - Diana R Elbourne
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew J Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Robert M Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Steven N Goodman
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Robina, QLD, Australia
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Centre at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - Brennan C Kahan
- MRC Clinical Trials Unit at University College London, London, UK
| | - Rachel L Knowles
- University College London, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sarah E Lamb
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Steff Lewis
- Edinburgh Clinical Trials Unit, Usher Institute-University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK
| | - Elizabeth Loder
- The BMJ, BMA House, London, UK
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Martin Offringa
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Philippe Ravaud
- Université Paris Cité, Inserm, INRAE, Centre de Recherche Epidémiologie et Statistiques, Université Paris Cité, Paris, France
| | | | - Frank W Rockhold
- Duke Clinical Research Institute, Duke University Medical Centre, Durham, NC, USA
| | - David L Schriger
- Department of Emergency Medicine, University of California, Los Angeles, CA, USA
| | - Nandi L Siegfried
- Mental Health, Alcohol, Substance Use, and Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Sophie Staniszewska
- Warwick Applied Health, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit and Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Lehana Thabane
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, ON, Canada
- St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - David J Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Sunita Vohra
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ian R White
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Centre at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
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5
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Hopewell S, Chan AW, Collins GS, Hróbjartsson A, Moher D, Schulz KF, Tunn R, Aggarwal R, Berkwits M, Berlin JA, Bhandari N, Butcher NJ, Campbell MK, Chidebe RCW, Elbourne D, Farmer A, Fergusson DA, Golub RM, Goodman SN, Hoffmann TC, Ioannidis JPA, Kahan BC, Knowles RL, Lamb SE, Lewis S, Loder E, Offringa M, Ravaud P, Richards DP, Rockhold FW, Schriger DL, Siegfried NL, Staniszewska S, Taylor RS, Thabane L, Torgerson D, Vohra S, White IR, Boutron I. CONSORT 2025 explanation and elaboration: updated guideline for reporting randomised trials. BMJ 2025; 389:e081124. [PMID: 40228832 PMCID: PMC11995452 DOI: 10.1136/bmj-2024-081124] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2025] [Indexed: 04/16/2025]
Affiliation(s)
- Sally Hopewell
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford OX3 7LD, UK
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
| | - Gary S Collins
- UK EQUATOR Centre, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Programme, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Kenneth F Schulz
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ruth Tunn
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford OX3 7LD, UK
| | - Rakesh Aggarwal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Michael Berkwits
- Office of Science Dissemination, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jesse A Berlin
- Department of Biostatistics and Epidemiology, School of Public Health, Center for Pharmacoepidemiology and Treatment Science, Rutgers University, New Brunswick, NJ, USA
- JAMA Network Open, Chicago, IL, USA
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nancy J Butcher
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Marion K Campbell
- Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen, UK
| | - Runcie C W Chidebe
- Project PINK BLUE - Health & Psychological Trust Centre, Utako, Abuja, Nigeria
- Department of Sociology and Gerontology, Miami University, OH, USA
| | - Diana Elbourne
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Robert M Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Steven N Goodman
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, University Drive, Robina, QLD, Australia
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - Brennan C Kahan
- MRC Clinical Trials Unit at University College London, London, UK
| | - Rachel L Knowles
- University College London, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sarah E Lamb
- NIHR Exeter Biomedical Research Centre, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Steff Lewis
- Edinburgh Clinical Trials Unit, Usher Institute-University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK
| | - Elizabeth Loder
- The BMJ, BMA House, London, UK
- Harvard Medical School, Boston, MA, USA
| | - Martin Offringa
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Philippe Ravaud
- Université Paris Cité, Inserm, INRAE, Centre de Recherche Epidémiologie et Statistiques, Université Paris Cité, Paris, France
| | | | - Frank W Rockhold
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | - David L Schriger
- Department of Emergency Medicine, University of California, Los Angeles, CA, USA
| | | | - Sophie Staniszewska
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Lehana Thabane
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, ON, Canada
- St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - David Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Sunita Vohra
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ian R White
- MRC Clinical Trials Unit at University College London, London, UK
| | - Isabelle Boutron
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France
- Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, AP-HP, Paris, France
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6
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Chan AW, Boutron I, Hopewell S, Moher D, Schulz KF, Collins GS, Tunn R, Aggarwal R, Berkwits M, Berlin JA, Bhandari N, Butcher NJ, Campbell MK, Chidebe RCW, Elbourne DR, Farmer AJ, Fergusson DA, Golub RM, Goodman SN, Hoffmann TC, Ioannidis JPA, Kahan BC, Knowles RL, Lamb SE, Lewis S, Loder E, Offringa M, Ravaud P, Richards DP, Rockhold FW, Schriger DL, Siegfried NL, Staniszewska S, Taylor RS, Thabane L, Torgerson DJ, Vohra S, White IR, Hróbjartsson A. SPIRIT 2025 statement: Updated guideline for protocols of randomised trials. PLoS Med 2025; 22:e1004589. [PMID: 40294521 PMCID: PMC12037212 DOI: 10.1371/journal.pmed.1004589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2025] Open
Abstract
IMPORTANCE The protocol of a randomised trial is the foundation for study planning, conduct, reporting, and external review. However, trial protocols vary in their completeness and often do not address key elements of design and conduct. The SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement was first published in 2013 as guidance to improve the completeness of trial protocols. Periodic updates incorporating the latest evidence and best practices are needed to ensure that the guidance remains relevant to users. OBJECTIVE To systematically update the SPIRIT recommendations for minimum items to address in the protocol of a randomised trial. DESIGN We completed a scoping review and developed a project specific database of empirical and theoretical evidence to generate a list of potential changes to the SPIRIT 2013 checklist. The list was enriched with recommendations provided by lead authors of existing SPIRIT/CONSORT (Consolidated Standards of Reporting Trials) extensions (Harms, Outcomes, Non-pharmacological Treatment) and other reporting guidelines (TIDieR). The potential modifications were rated in a three-round Delphi survey followed by a consensus meeting. FINDINGS Overall, 317 individuals participated in the Delphi consensus process and 30 experts attended the consensus meeting. The process led to the addition of two new protocol items, revision to five items, deletion/merger of five items, and integration of key items from other relevant reporting guidelines. Notable changes include a new open science section, additional emphasis on the assessment of harms and description of interventions and comparators, and a new item on how patients and the public will be involved in trial design, conduct, and reporting. The updated SPIRIT 2025 statement consists of an evidence-based checklist of 34 minimum items to address in a trial protocol, along with a diagram illustrating the schedule of enrolment, interventions, and assessments for trial participants. To facilitate implementation, we also developed an expanded version of the SPIRIT 2025 checklist and an accompanying explanation and elaboration document. CONCLUSIONS AND RELEVANCE Widespread endorsement and adherence to the updated SPIRIT 2025 statement have the potential to enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, funders, research ethics committees, journals, trial registries, policymakers, regulators, and other reviewers.
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Affiliation(s)
- An-Wen Chan
- Department of Medicine, Women’s College Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Isabelle Boutron
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France
- Centre d’Epidémiologie Clinique, Hôpital Hôtel Dieu, AP-HP, Paris, France
| | - Sally Hopewell
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Programme, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kenneth F. Schulz
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Gary S. Collins
- UK EQUATOR Centre, Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
| | - Ruth Tunn
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
| | - Rakesh Aggarwal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Michael Berkwits
- Office of Science Dissemination, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jesse A. Berlin
- Department of Biostatistics and Epidemiology, School of Public Health, Center for Pharmacoepidemiology and Treatment Science, Rutgers University, New Brunswick, New Jersey, United States of America
- JAMA Network Open, Chicago, Illinois, United States of America
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nancy J. Butcher
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Marion K. Campbell
- Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen, United Kingdom
| | - Runcie C. W. Chidebe
- Project PINK BLUE—Health & Psychological Trust Centre, Utako, Abuja, Nigeria
- Department of Sociology and Gerontology, Miami University, Ohio, United States of America
| | - Diana R. Elbourne
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Andrew J. Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Robert M. Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Steven N. Goodman
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, California, United States of America
| | - Tammy C. Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, University Drive, Robina, Queensland, Australia
| | - John P. A. Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, United States of America
| | - Brennan C. Kahan
- MRC Clinical Trials Unit at University College London, London, United Kingdom
| | - Rachel L. Knowles
- University College London, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Sarah E. Lamb
- NIHR Exeter Biomedical Research Centre, Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Steff Lewis
- Edinburgh Clinical Trials Unit, Usher Institute-University of Edinburgh, Edinburgh BioQuarter, Edinburgh, United Kingdom
| | - Elizabeth Loder
- The BMJ, BMA House, London, United Kingdom
- Harvard Medical School, Boston, Massachusetts, United States of America
| | - Martin Offringa
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Philippe Ravaud
- Université Paris Cité, Inserm, INRAE, Centre de Recherche Epidémiologie et Statistiques, Université Paris Cité, Paris, France
| | | | - Frank W. Rockhold
- Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, United States of America
| | - David L. Schriger
- Department of Emergency Medicine, University of California, Los Angeles, California, United States of America
| | | | - Sophie Staniszewska
- Warwick Applied Health, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Rod S. Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Lehana Thabane
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- St Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | - David J. Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, United Kingdom
| | - Sunita Vohra
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ian R. White
- MRC Clinical Trials Unit at University College London, London, United Kingdom
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
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7
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Mathieu S, Bouillon-Minois JB, Renard Triché L, Coudeyre E, Ingrid DC, Thomas F, Laporte C, Moisset X, Samalin L, Villatte G, Pereira B. Protocol publication rate and comparison between article, registry and protocol in RCTs. BMC Med Res Methodol 2025; 25:31. [PMID: 39893396 PMCID: PMC11786558 DOI: 10.1186/s12874-025-02471-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 01/15/2025] [Indexed: 02/04/2025] Open
Abstract
BACKGROUND Increasing transparency in clinical research is crucial to avoid misleading conclusions. Registering clinical trials prior to participant enrolment is mandatory, and the publication of trial protocols could further enhance transparency. However, the impact of protocol publication on primary outcomes (PO) and sample sizes (SS) remains unclear. This study aimed to determine the rates of trial protocol publication and registration for a sample of randomized controlled trials (RCTs) and to compare the consistency of published and registered PO and SS. METHODS A search was conducted in MEDLINE via PubMed® for RCT reports indexed in May and June 2023 across various medical specialties, focusing on general and high-impact factor journals. Data were extracted regarding trial registration, protocol publication, and comparisons were made between PO and SS in articles, registries, and published protocols. RESULTS Out of 1119 references, 589 (52.6%) were RCTs. The corresponding protocol was published for 146 RCTs (24.8%) including 40 over 140 (28.6%) (6 without end date available) after the trial had ended. Sixty-two (42.4%) protocols were published before the trial conclusion, with no significant differences between PO and SS in published protocols and their corresponding articles. Five hundred and twenty-eight (89.6%) RCTs were registered, 225 over 510 (44%) were registered before the study start with no differences in PO and SS between article and registry. Articles published in generalist or high impact factor journals were associated with higher frequencies of published protocols and trial registration and a lower frequency of difference in PO and SS between articles, registries, and published protocols. CONCLUSIONS While publishing trial protocols may enhance transparency in peer-review process, the initial registered protocol alone appears sufficient for ensuring consistency in primary outcomes and sample sizes. Protocol publication does not seem to provide additional significant benefits in terms of outcome reporting.
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Affiliation(s)
- Sylvain Mathieu
- Rheumatology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France.
- CHU Clermont-Ferrand, Neuro-Dol, Université Clermont Auvergne, Inserm, Clermont- Ferrand, France.
- Rheumatology Department, Gabriel Montpied Teaching Hospital, 58 Rue Montalembert, Clermont-Ferrand, 63003, France.
| | | | - Laurent Renard Triché
- Department of Perioperative Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
- CNRS UMR6293, INSERM U1103, Université Clermont Auvergne, Clermont- Ferrand, France
- Statistic and Epidemiologic Research Center Sorbonne Paris Cité (CRESS), Epidemiology and Clinical Statistics for Tumor, Respiratory, and Resuscitation Assessments (ECSTRRA) Team, INSERM UMR1153, Université Paris Cité, Paris, France
| | - Emmanuel Coudeyre
- Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, Hôpital Louise Michel, INRAE, Université Clermont Auvergne, Clermont-Ferrand, France
| | - De Chazeron Ingrid
- Service de Psychiatrie Adulte et d'Addictologie, CHU Clermont-Ferrand, CNRS, Université Clermont-Auvergne, Institut Pascal, Clermont-Ferrand, France
| | - Finotto Thomas
- Department of Perioperative Medicine, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Catherine Laporte
- Département de Médecine Générale, Université Clermont Auvergne, UFR de Médecine et Profession paramédicales de Clermont-Ferrand, Clermont-Ferrand, F-63000, France
- Université Clermont Auvergne, CNRS, UMR 6602, Clermont-Ferrand, F-63000, France
| | - Xavier Moisset
- CHU Clermont-Ferrand, Neuro-Dol, Université Clermont Auvergne, Inserm, Clermont- Ferrand, France
| | - Ludovic Samalin
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, CNRS, UMR 6602, Clermont-Ferrand, IP, France
| | - Guillaume Villatte
- Clermont Auvergne University, CNRS, SIGMA Clermont, ICCF, Clermont-Ferrand, France
- Department of Orthopaedic Surgery, CHU Montpied Clermont-Ferrand, Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics Unit (DRCI), 55174 CHU Clermont-Ferrand, Clermont-Ferrand, France
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8
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Purgar M, Glasziou P, Klanjscek T, Nakagawa S, Culina A. Supporting study registration to reduce research waste. Nat Ecol Evol 2024; 8:1391-1399. [PMID: 38839851 DOI: 10.1038/s41559-024-02433-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 05/08/2024] [Indexed: 06/07/2024]
Abstract
An estimated 82-89% of ecological research and 85% of medical research has limited or no value to the end user because of various inefficiencies. We argue that registration and registered reports can enhance the quality and impact of ecological research. Drawing on evidence from other fields, chiefly medicine, we support our claim that registration can reduce research waste. However, increasing registration rates, quality and impact will be very slow without coordinated effort of funders, publishers and research institutions. We therefore call on them to facilitate the adoption of registration by providing adequate support. We outline several aspects to be considered when designing a registration system that would best serve the field of ecology. To further inform the development of such a system, we call for more research to identify the causes of low registration rates in ecology. We suggest short- and long-term actions to bolster registration and reduce research waste.
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Affiliation(s)
| | - Paul Glasziou
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | | | - Shinichi Nakagawa
- Evolution & Ecology Research Centre and School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, New South Wales, Australia
- Theoretical Sciences Visiting Program, Okinawa Institute of Science and Technology Graduate University, Onna, Japan
| | - Antica Culina
- Ruđer Bošković Institute, Zagreb, Croatia.
- Netherlands Institute of Ecology, Royal Netherlands Academy of Arts and Sciences, Wageningen, the Netherlands.
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9
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Sandbank M, Bottema-Beutel K, Syu YC, Caldwell N, Feldman JI, Woynaroski T. Evidence-b(i)ased practice: Selective and inadequate reporting in early childhood autism intervention research. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1889-1901. [PMID: 38345030 PMCID: PMC11301951 DOI: 10.1177/13623613241231624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
LAY ABSTRACT When researchers fail to report their findings or only report some of their findings, it can make it difficult for clinicians to provide effective intervention recommendations. However, no one has examined whether this is a problem in studies of early childhood autism interventions. We studied how researchers that study early childhood autism interventions report their findings. We found that most researchers did not register their studies when they were supposed to (before the start of the study), and that many researchers did not provide all of the needed information in the registration. We also found that researchers frequently did not publish their findings when their studies were complete. When we looked at published reports, we found that many of the studies did not report enough information, and that many studies were reported differently from their registrations, suggesting that researchers were selectively reporting positive outcomes and ignoring or misrepresenting less positive outcomes. Because we found so much evidence that researchers are failing to report their findings quickly and correctly, we suggested some practical changes to make it better.
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Affiliation(s)
| | | | - Ya-Cing Syu
- The University of North Carolina at Chapel Hill, USA
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10
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Duan Y, Deng Y, Tang B, Xu Z, Ye X, Lu M, Liu S, Xiong L, Zhu W, Yu L, Zhao P. Exploration of registration and the risk of bias in acupuncture randomised controlled trials: a systematic review protocol. BMJ Open 2024; 14:e083213. [PMID: 38772884 PMCID: PMC11110577 DOI: 10.1136/bmjopen-2023-083213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/09/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Randomised controlled trials (RCTs) are the predominant type in acupuncture clinical research, and the publications have increased rapidly in recent years, but there is a prevalence of the high risk of bias and poor methodological design in acupuncture RCTs. Clinical trial registration can improve the transparency and credibility of studies by disclosing key information in advance. However, the registration in acupuncture RCTs is not satisfactory, as there is widespread of the under-registration, inconsistency with published studies and insufficient disclosure of key methodological information. Whether registration can reduce the risk of bias in acupuncture RCTs and improve data transparency has not been fully explored. Therefore, we constructed this study to investigate the association between registration and risk of bias and data sharing level in acupuncture RCTs. METHODS Seven databases including MEDLINE, EMBASE, CENTRAL, CBM, CNKI, Wanfang and VIP databases will be systematically searched between 1 January 2014 and 31 March 2024, for acupuncture RCTs. Two reviewers will independently extract data using a predefined standardised format and perform secondary validation. The characteristics and data sharing level of the included studies will be summarised. The risk of bias of included RCTs will be assessed by the revised Cochrane risk-of-bias tool for randomised trials. The risk of bias and registration in acupuncture RCTs will be analysed by logistic or quantile regression analyses (depending on the number of minimum events). The data sharing level and registration will be analysed by quantile regression analyses. ETHICS AND DISSEMINATION As the systematic review aims to consolidate info from published sources, ethical approval is not necessary for this study. The study's findings will be submitted to a peer-reviewed academic journal and disseminated via conference presentations. This protocol has been registered in Open Science Framework Registries.
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Affiliation(s)
- Yuting Duan
- The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yuening Deng
- The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Binbin Tang
- Clinical School of Integrated Traditional Chinese and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhirui Xu
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiaolin Ye
- Clinical School of Integrated Traditional Chinese and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Manyi Lu
- Clinical School of Integrated Traditional Chinese and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shujuan Liu
- The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Linghui Xiong
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Weifeng Zhu
- The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lin Yu
- The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Pinge Zhao
- Department of Integrated Chinese and Western Medicine, Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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