What influences whether researchers adhere to healthcare reporting guidelines successfully? A thematic synthesis

Background
Despite endorsement by medical journals, reporting guidelines have only modestly affected reporting quality in healthcare research. We aimed to identify influences affecting whether authors successfully adhere to reporting guidelines.

Methods
We searched MEDLINE, Embase, PsychINFO, AMED, WHO Global Index Medicus, SciELO, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Data, VIP Chinese Medical Journal Database, OSF, and MiRoR for qualitative research exploring researchers’ experiences of reporting guidelines for healthcare research, published after 1996 in English, Chinese, Spanish, or Portuguese. We appraised studies using CASP-Qual. For thematic synthesis, we applied descriptive codes to all text reporting qualitative findings, then aggregated codes inductively into descriptive themes that captured the codes’ meaning. We interpreted and contextualised possible influences from these descriptive themes to create analytic themes.

Results
From 18 eligible studies, we developed 12 analytic themes: 1) Researchers may not understand guidance as intended or what reporting guidelines are, even if they think they do; 2) Researchers report a variety of reasons for using reporting guidelines, and some are more important than others; 3) Researchers describe using reporting guidelines for different tasks and wanting guidance delivered in ways that better fit their needs; 4) Using reporting guidelines has costs which researchers may feel outweigh benefits; 5) Reporting guidelines may need to be revised and updated; 6) Researchers may not be able to report all items, which can leave them feeling uncertain or worried; 7) Awareness and accessibility may limit reporting guideline usage; 8) Reporting guidelines may be more useful to less experienced researchers, but these researchers may find them harder to use; 9) Researchers want or need design advice, but reporting guidelines may not be the right place to find it; 10) Reporting guidelines can be harder to use if their scope is too broad, too narrow, or poorly defined; 11) Researchers may have to use multiple sets of reporting guidelines, multiplying complexity and costs; 12) Researchers may use checklists but never read the full guidance.

Discussion
We identified many influences despite a paucity of evidence. Addressing these influences when developing, refining, and implementing reporting guidelines may improve adherence.