Improving the quality of reporting of randomized controlled trials. The CONSORT statement.

THE RANDOMIZED controlled trial (RCT), more than any other methodology, can have a powerful and immediate impact on patient care. Ideally, the report of such an evaluation needs to convey to the reader relevant information concerning the design, conduct, analysis, and generalizability of the trial. This information should provide the reader with the ability to make informed judgments regarding the internal and external validity of the trial. Accurate and complete reporting also benefits editors and reviewers in their deliberations regarding submitted manuscripts. For RCTs to ultimately benefit patients, the published report should be of the highest possible standard. For editorial comment see p 649. Evidence produced repeatedly over the last 30 years indicates a wide chasm between what a trial should report and what is actually published in the literature. In a review of 71 RCTs with negative results published between 1960 and 1975, the authors reported that the vast

[1]  T C Chalmers,et al.  Ascorbic acid for the common cold. A prophylactic and therapeutic trial. , 1975, JAMA.

[2]  T C Chalmers,et al.  The importance of beta, the type II error and sample size in the design and interpretation of the randomized control trial. Survey of 71 "negative" trials. , 1978, The New England journal of medicine.

[3]  R. Fletcher,et al.  Clinical research in general medical journals: a 30-year perspective. , 1979, The New England journal of medicine.

[4]  M. Evans,et al.  Trials on trial. A review of trials of antibiotic prophylaxis. , 1984, Archives of surgery.

[5]  S. Pocock,et al.  Clinical Trials: A Practical Approach , 1984 .

[6]  K. Godfrey Comparing the Means of Several Groups , 1985, Medical Uses of Statistics.

[7]  M J Campbell,et al.  Use of check lists in assessing the statistical content of medical studies. , 1986, British medical journal.

[8]  M. Gardner,et al.  Confidence intervals rather than P values: estimation rather than hypothesis testing. , 1986, British medical journal.

[9]  S. Pocock,et al.  Statistical problems in the reporting of clinical trials. A survey of three medical journals. , 1987, The New England journal of medicine.

[10]  F. Gutzwiller,et al.  A proposal for more informative abstracts of clinical articles. Ad Hoc Working Group for Critical Appraisal of the Medical Literature. , 1987, Annals of internal medicine.

[11]  J C Bailar,et al.  Guidelines for statistical reporting in articles for medical journals. Amplifications and explanations. , 1988, Annals of internal medicine.

[12]  P. Gøtzsche Methodology and overt and hidden bias in reports of 196 double-blind trials of nonsteroidal antiinflammatory drugs in rheumatoid arthritis. , 1989, Controlled clinical trials.

[13]  M J Gardner,et al.  An exploratory study of statistical assessment of papers published in the British Medical Journal. , 1990, JAMA.

[14]  A Donner,et al.  A methodological review of non-therapeutic intervention trials employing cluster randomization, 1979-1989. , 1990, International journal of epidemiology.

[15]  D. G. Altman,et al.  Randomisation and baseline comparisons in clinical trials , 1990, The Lancet.

[16]  J H Ellenberg,et al.  Analysis of clinical trials by treatment actually received: is it really an option? , 1991, Statistics in medicine.

[17]  G H Guyatt,et al.  A Consumer's Guide to Subgroup Analyses , 1992, Annals of Internal Medicine.

[18]  S. Pocock,et al.  When to stop a clinical trial. , 1992, BMJ.

[19]  D. Moher,et al.  Statistical power, sample size, and their reporting in randomized controlled trials. , 1994, JAMA.

[20]  T R Einarson,et al.  Quality of nonstructured and structured abstracts of original research articles in the British Medical Journal, the Canadian Medical Association Journal and the Journal of the American Medical Association. , 1994, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[21]  Curtis L. Meinert,et al.  A proposal for structured reporting of randomized controlled trials. The Standards of Reporting Trials Group. , 1994, JAMA.

[22]  K. Dickersin,et al.  Systematic Reviews: Identifying relevant studies for systematic reviews , 1994 .

[23]  D G Altman,et al.  The scandal of poor medical research , 1994, BMJ.

[24]  D G Altman,et al.  Assessing the quality of randomization from reports of controlled trials published in obstetrics and gynecology journals. , 1994, JAMA.

[25]  D. Rennie Reporting randomized controlled trials. An experiment and a call for responses from readers. , 1995, JAMA.

[26]  K. Schulz,et al.  Subverting randomization in controlled trials. , 1995, JAMA.

[27]  J. Davis Use of brand names in place of generics. , 1995, JAMA.

[28]  R. J. Hayes,et al.  Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. , 1995, JAMA.

[29]  G P Samsa,et al.  Randomized controlled trial of 3 vs 10 days of trimethoprim/sulfamethoxazole for acute maxillary sinusitis. , 1995, JAMA.

[30]  R. J. Hayes,et al.  Blinding and exclusions after allocation in randomised controlled trials: survey of published parallel group trials in obstetrics and gynaecology , 1996, BMJ.

[31]  A R Jadad,et al.  Assessing the quality of reports of randomized clinical trials: is blinding necessary? , 1996, Controlled clinical trials.