This study is based on experiences from editors, reviewers, authors of systematic reviews and readers of the scientific literature. The applicability of the principles has not been evaluated in real practice. Only when authors start to use these principles for reporting, shortcomings in the principles will emerge.

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Conventional exercise electrocardiographic criteria usually involve patterns with a horizontal or downsloping ST segment. In the present study we present criteria based on upsloping ST segments and compared these criteria with the conventional criteria. Using upsloping ST-segment criteria, the amount of ST-segment depression at 80 msec after the end of the QRS complex is used as a parameter (ST criterion E, with a depression of 100 mV, and ST criterion F, with a depression of 200 mV). In the graded exercise test a bicycle ergometer was used. The ECG leads were CM5 and CC5. The results of exercise electrocardiography were compared with the findings from coronary arteriography. In 623 selected patients (565 males and 58 females), application of conventional ST criteria gave a sensitivity of 56% and a specificity of 94%; with application of the ST criteria E or F, sensitivity was 75% and specificity 90%. In the 58 females use of these new criteria resulted in a sensitivity of 76% and specificity of 88%. Ninety-three patients (15%) could be classified as positive exercise responders by the sole presence of an upsloping ST segment (type E or F). Sixty-eight percent of the patients with type E and 75% with type F had two- or three-vessel disease (coronary obstructions greater their or equal to 50%). We conclude that ST criteria based on upsloping ST segments significantly increase the diagnostic yield of the exercise ECG.

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SummaryBackground: Improving the quality of reporting of evaluation studies in health informatics is an important requirement towards the vision of evidence-based health informatics. The STARE-HIStatement on Reporting of Evaluation Studies in health informatics, published in 2009, provides guidelines on the elements to be contained in an evaluation study report. Objectives: To elaborate on and provide a rationale for the principles of STARE-HI and to guide authors and readers of evaluation studies in health informatics by providing explanatory examples of reporting. Methods: A group of methodologists, researchers and editors prepared the present elaboration of the STARE-HI statement and selected examples from the literature. Results: The 35 STARE-HI items to be addressed in evaluation papers describing health informatics interventions are discussed one by one and each is extended with examples and elaborations. Conclusion: The STARE-HI statement and this elaboration document should be helpful resources to improve reporting of both quantitative and qualitative evaluation studies. Evaluation manuscripts adhering to the principles will enable readers of such papers to better place the studies in a proper context and judge their validity and generalizability, and thus in turn optimize the exploitation of the evidence contained therein. Limitations: This paper is based on experiences of a group of editors, reviewers, authors of systematic reviews and readers of the scientific literature. The applicability of the details of these principles has to evolve as a function of their use in practice.