"Assessing the Quality of Reporting on Quality Improvement Initiatives in Breast Reconstruction - A Systematic Review".

BACKGROUND
There has been a recent increase in the number and complexity of quality improvement studies in breast reconstruction. To assist with the development of thorough quality improvement reporting practices, with the goal of improving the transferability of these initiatives, we conducted a systematic review of studies describing the implementation of quality improvement initiatives in breast reconstruction. We used the SQUIRE 2.0 guideline to appraise the quality of reporting of these initiatives.


METHODS
English language articles published in EMBASE, MEDLINE, CINAHL, and the Cochrane databases were searched. Quantitative studies evaluating the implementation of QI initiatives in breast reconstruction were included. The primary endpoint of interest in this review was the distribution of studies per SQUIRE 2.0 criteria scores in proportions. Abstracts and full-text screening, and data extraction were completed independently and in duplicate by the review team.


RESULTS
We screened 1107 studies, of which 53 full texts were assessed and 35 met inclusion criteria. In our assessment, only 3 studies (9%) met all 18 SQUIRE 2.0 criteria. SQUIRE 2.0 criteria that were met most frequently were abstract, problem description, rationale and analysis. The lowest SQUIRE 2.0 scores appeared in the interpretation criteria.


CONCLUSION
Significant opportunity exists to improve quality improvement reporting in breast reconstruction, especially in the realm of costs, strategic trade-offs, ethical considerations, project sustainability and potential for spread to other contexts. Improvements in these areas will help to further advance the transferability of QI initiatives in breast reconstruction.