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Guide to Statistics and Methods
Reporting Guidelines
April 7, 2021

SQUIRE Reporting Guidelines for Quality Improvement Studies

Author Affiliations
  • 1Division of Endocrine and Oncologic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia
  • 2Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia
  • 3Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
  • 4Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
  • 5Statistical Editor, JAMA Surgery
  • 6Division of Acute Care Surgery, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 7Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 8Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 9The Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland
  • 10Department of Health Policy and Management, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
JAMA Surg. 2021;156(6):579-581. doi:10.1001/jamasurg.2021.0531

The science of quality and safety is different from traditional science in so many ways that early attempts to define improvement work as science often generated tremendous debate and even contempt in the scientific community. Further, initial efforts to share findings and disseminate knowledge in the field by way of scholarly publication were limited by an inability to conform to traditional templates used when publishing scientific findings based on hypothesis testing. In 1999, the Quality Improvement Report Guidelines1 were published to guide manuscript preparation for studies on local quality improvement. In response to continued confusion on how to format these manuscripts in a structured, meaningful fashion, the Standards for Quality Improvement Reporting Excellence (SQUIRE) reporting guideline was released in 2008 and revised in 2015 (SQUIRE 2.0).2 SQUIRE 2.0 was developed using a combination of semistructured interviews and focus groups with end users, expert engagement in the interpretation of the interviews, and pilot testing. The guideline provides direction on how to report systematic efforts in health care improvement regardless of the specific approach used. A summary of the guideline is presented in the Box. While SQUIRE is less frequently used than other frameworks (eg, Consolidated Standards of Reporting Trials [CONSORT]), we hope this article helps elevate its use in the field of surgery. One reason for its limited use may be the lack of requirement for its use by many journals.

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