STARD WARS

I’m working on my MSc dissertation (Sensitivity and specificity of molecular methods for detecting markers of antimalarial resistance in clinical samples of Plasmodium falciparum: a systematic review) and I’ve been trying to track down eligible studies.

All the studies should be easily found in bibliographic databases, and all the data I need should be in the published papers, right?

Of the 35 potentially eligible studies:

  • 17 report too little data for me to be able to extract the results I need.

What would the results of my review be if I could include this data? Maybe leaving out nearly 50% of eligible studies which report data from over 50% of participants isn’t ideal and might affect the validity of my results?

I thought trial registries might be useful for finding out more.

Of 35 potentially eligible studies:

  • None were registered, either prospectively or retrospectively.

(One study had an associated study of adherence to rapid diagnostic tests registered – results not provided).

So I have no idea if study protocols were changed, had missing outcomes, new outcomes…

Trial registries were not helpful for checking details of studies I know exist. How many studies are there that I don’t know exist?

Are my systematic review results going to be bollocks due to all the different biases introduced by crappy study designs and ad hoc changes, unpublished studies, outcome switching, and missing data from published studies?

And how can I find out, if I can’t ever know how much data I’m missing or how biased the data I have is?

It should be so simple..

REGISTER AND REPORT – diagnostic test accuracy studies can be registered at any of the registries listed in Table 1 of this great paper, and should be registered somewhere prospectively. They should be reported according to STARD.

Even using the resources I have free and easy access to – the Bodleian, the British Library, and kind friends at plenty of other institutions with awesome libraries, I still couldn’t get all the papers I might have wanted. So what is everyone else supposed to do?

OPEN ACCESS – often funded by public money, often work done by public employees, time and samples and personal data always donated by members of the public – make OUR data available to us, the people you’re doing it for/with.

Fair disclosure, we didn’t register the one study on which I’m a co-author. Or report it following STARD. I am going to register it retrospectively. And we did report enough data in the published paper for inclusion in my systematic review.

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