Publishing health research is a thriving, and increasing, enterprise. On any given month about 63,000 new articles are indexed in PubMed, the United States National Library of Medicine's public access portal for health-related publications. However, the quality of reporting in most health care journals remains inadequate. Glasziou and colleagues  assessed descriptions of given treatments in 80 trials and systematic reviews for which summaries were published during one year (October 2005 to October 2006) in Evidence-Based Medicine, a journal that is aimed at physicians working in primary care and general medicine. Treatment descriptions were inadequate in 41 of the original published articles, which made their use in clinical practice difficult if not impossible to replicate. This is just one of numerous examples of a large and disturbing literature indicating the general failure in the quality of reporting health research –. Many publications lack clarity, transparency, and completeness in how the authors actually carried out their research.
Inadequate reporting is problematic for several reasons. If authors do not provide sufficient details concerning the conduct of their study, readers are left with an incomplete picture of what was done. As such, they are not able to judge the reliability of the results and interpret them. There are also ethical and moral reasons for reporting research adequately .
The EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network is a new international initiative seeking to improve the quality of scientific publications by promoting transparent and accurate reporting . The Network (http://www.equator-network.org) provides resources and training relating to the reporting of health research and assists in the development, dissemination, and implementation of reporting guidelines. As part of its initial resource development, the Network's Web site contains a comprehensive and up-to-date database of reporting guidelines relevant to heath research. A recent systematic review of 81 reporting guidelines found their development was often inadequate .
Reporting guidelines need to be differentiated from other efforts that produce a checklist or other guidance not specific to reporting research. We propose here a working definition of a reporting guideline: a checklist, flow diagram, or explicit text to guide authors in reporting a specific type of research, developed using explicit methodology. Some reporting guidelines recommend a flow diagram so that authors can clearly report information about sequential stages of their research project. A consensus process  should be a crucial characteristic of developing a reporting guideline.
The main motivation for the development of reporting guidelines is to help researchers improve the completeness and transparency of their research reports and limit the number of poorly reported studies. However, reporting guidelines can be also used by peer reviewers and editors to strengthen manuscript review. And research funders can benefit from introducing reporting guidelines into the research application system . Ensuring clear and complete reporting of funded research through the use of reporting guidelines should facilitate more efficient use of the new findings and bring better returns on research investments. There are enormous potential benefits of good reporting. However, despite the impressive recent upsurge in the number and range of reporting guidelines, the literature on how individual guidelines were developed remains sparse , and there is no generic guidance on how to develop one.
In this paper we update and expand upon an earlier effort to outline a strategy for developing reporting guidelines that was published only in Spanish . We recognize that there is no single best or correct approach. However, this paper benefits from our collective experiences of helping to develop more than ten reporting guidelines over the last 16 years, over which period these ideas have evolved considerably. If reporting guidelines are to be useful and more widely disseminated, they need to be developed using robust and widely accepted methodologies.
This strategy assumes the involvement of an executive group to facilitate the guideline development and the expectation of having a face-to-face meeting as part of the reporting guideline development. We propose 18 steps to occur in five phases, which are outlined in Table 1.