Reporting Quality of Randomized Controlled Trials in Elective Hand Surgery: A Systematic Review

The Consolidated Standards of Reporting Trials-Nonpharmacologic Treatment guidelines aim to enhance the reporting quality of randomized controlled trials (RCTs) by promoting transparency, reproducibility, and reduced bias. Compliance of RCTs with these checklist criteria ensures transparency and reproducibility. Poor methodological reporting undermines study reproducibility and reliability of clinical recommendations. This systematic review assessed the adherence of RCTs in elective hand surgery (EHS) to the latest guidelines.

After PROSPERO registration (CRD42025630289), a search was conducted in January 2025 across Cochrane, Embase, PubMed, and Web of Science for RCTs in EHS published since 2017. Two independent reviewers assessed studies against 42 Consolidated Standards of Reporting Trials-Nonpharmacologic Treatments subcriteria. Overall compliance to each subcriterion and overall compliance of each RCT were calculated.

Fifty-eight RCTs met inclusion criteria, with a mean compliance of 66.1%. The most consistently reported items were "scientific background and rationale" and "participant allocation details" (100% each). The least reported were "attempts to limit bias without blinding" (13.2%) and "modifications to outcomes post commencement" (17.2%). The "methods" section had the lowest section-wise compliance (55.7%). A weak but significant correlation was found between author count and compliance (P = 0.0123, R ² = 0.103); no significant correlation was observed with journal impact factor (P = 0.26, R ² = 0.01) or citations per year (P = 0.1105, r = 0.2112).

Reporting quality of RCTs in EHS remains moderate, with critical gaps in methodological transparency. Stronger collaboration among researchers, journals, funding agencies, and guideline developers is necessary to enhance adherence and ensure high-quality evidence.