Revised Strengthening the Reporting of Cohort, Cross-Sectional and Case-Control Studies in Surgery (STROCSS) Guideline: An Update for the Age of Artificial Intelligence

Riaz A. Agha; Ginimol Mathew; Rasha Rashid; Ahmed Kerwan; Ahmed Al-Jabir; Catrin Sohrabi; Thomas Franchi; Maria Nicola; Maliha Agha; Achilleas Thoma; Alessandro Coppola; Andrew J. Beamish; Ashraf Noureldin; Ashwini Rao; Baskaran Vasudevan; Ben Challacombe; C. S. Pramesh; Duilio Pagano; Frederick Heaton Millham; Gaurav Roy; Huseyin Kadioglu; Iain James Nixon; Indraneil Mukherjee; James Anthony McCaul; James Ngu; Joerg Albrecht; Juan Gomez Rivas; K. Veena L. Karanth; Kandiah Raveendran; M. Hammad Ather; Mangesh A. Thorat; Mohammad Bashashati; Mushtaq Chalkoo; Oliver J. Muensterer; Patrick Bradley; Prabudh Goel; Prathamesh Pai; Priya Shinde; Priya Ranganathan; Raafat Yahia Afifi Mohamed; Richard David Rosin; Roberto Cammarata; Roberto Coppola; Rolf Wynn; Salim Surani; Salvatore Giordano; Samuele Massarut; Shahzad G. Raja; Somprakas Basu; Syed Ather Enam; Teo Nan Zun; Todd Manning; Veeru Kasivisvanathan; Vincenzo La Vaccara; Zubing Mei

doi:10.70389/PJS.100081

Revised Strengthening the Reporting of Cohort, Cross-Sectional and Case-Control Studies in Surgery (STROCSS) Guideline: An Update for the Age of Artificial Intelligence

Riaz A. Agha, Ginimol Mathew, Rasha Rashid, Ahmed Kerwan, Ahmed Al-Jabir, Catrin Sohrabi, Thomas Franchi, Maria Nicola, Maliha Agha, Achilleas Thoma, Alessandro Coppola, Andrew J. Beamish, Ashraf Noureldin, Ashwini Rao, Baskaran Vasudevan, Ben Challacombe, C. S. Pramesh, Duilio Pagano, Frederick Heaton Millham, Gaurav RoyHuseyin Kadioglu, Iain James Nixon, Indraneil Mukherjee, James Anthony McCaul, James Ngu, Joerg Albrecht, Juan Gomez Rivas, K. Veena L. Karanth, Kandiah Raveendran, M. Hammad Ather, Mangesh A. Thorat, Mohammad Bashashati, Mushtaq Chalkoo, Oliver J. Muensterer, Patrick Bradley, Prabudh Goel, Prathamesh Pai, Priya Shinde, Priya Ranganathan, Raafat Yahia Afifi Mohamed, Richard David Rosin, Roberto Cammarata, Roberto Coppola, Rolf Wynn, Salim Surani, Salvatore Giordano, Samuele Massarut, Shahzad G. Raja, Somprakas Basu, Syed Ather Enam, Teo Nan Zun, Todd Manning, Veeru Kasivisvanathan, Vincenzo La Vaccara, Zubing Mei

Research output: Contribution to journal › Review article › peer-review

14 Citations (Scopus)

Abstract

INTRODUCTION Artificial intelligence (AI) is rapidly transforming healthcare and scientific publishing. Reporting guidelines need to be updated to take into account this advance. The STROCSS Guideline 2025 update adds a new AI-focused domain to promote transparency, reproducibility, and ethical integrity in surgical observational studies involving AI. METHODS A Delphi consensus exercise was conducted to update the STROCSS guidelines. A panel of 49 surgical and scientific experts were invited to rate proposed new items. In Round 1, participants scored each item on a nine-point Likert scale and provided feedback. Items not meeting consensus were revised or discarded. RESULTS A 94% response rate occurred among participants (46/49) in the first round. Ratings were analyzed for agreement levels, and consensus was reached on all six proposed AI-related items. A revised STROCSS checklist is presented which incorporates these new AI-related items. Authors are now expected to disclose AI involvement not only in patient care but also in manuscript preparation, as exemplified by this article. CONCLUSION The STROCSS 2025 guideline provides an up-to-date framework for surgical observational studies in the era of AI. Through a robust consensus STROCSS, we have added specific reporting criteria for AI to ensure that any use of artificial intelligence in a surgical observational study is clearly documented, explained, and discussed including with respect to bias and ethics. This update will help maintain the quality, transparency, and clinical relevance of surgical observational studies, ultimately improving their educational value and trustworthiness for the surgical community.

Original language	English (US)
Article number	100081
Journal	Premier Journal of Science
Volume	10
DOIs	https://doi.org/10.70389/PJS.100081
Publication status	Published - Jul 2025

Keywords

AI reporting standards
AI transparency and ethics
Artificial intelligence in surgery
Delphi consensus STROCSS
STROCSS guideline update

Access to Document

10.70389/PJS.100081

Cite this

Agha, R. A., Mathew, G., Rashid, R., Kerwan, A., Al-Jabir, A., Sohrabi, C., Franchi, T., Nicola, M., Agha, M., Thoma, A., Coppola, A., Beamish, A. J., Noureldin, A., Rao, A., Vasudevan, B., Challacombe, B., Pramesh, C. S., Pagano, D., Millham, F. H., ... Mei, Z. (2025). Revised Strengthening the Reporting of Cohort, Cross-Sectional and Case-Control Studies in Surgery (STROCSS) Guideline: An Update for the Age of Artificial Intelligence. Premier Journal of Science, 10, Article 100081. https://doi.org/10.70389/PJS.100081

@article{a7b908c60d96466aa78878b16f548f62,

title = "Revised Strengthening the Reporting of Cohort, Cross-Sectional and Case-Control Studies in Surgery (STROCSS) Guideline: An Update for the Age of Artificial Intelligence",

abstract = "INTRODUCTION Artificial intelligence (AI) is rapidly transforming healthcare and scientific publishing. Reporting guidelines need to be updated to take into account this advance. The STROCSS Guideline 2025 update adds a new AI-focused domain to promote transparency, reproducibility, and ethical integrity in surgical observational studies involving AI. METHODS A Delphi consensus exercise was conducted to update the STROCSS guidelines. A panel of 49 surgical and scientific experts were invited to rate proposed new items. In Round 1, participants scored each item on a nine-point Likert scale and provided feedback. Items not meeting consensus were revised or discarded. RESULTS A 94\% response rate occurred among participants (46/49) in the first round. Ratings were analyzed for agreement levels, and consensus was reached on all six proposed AI-related items. A revised STROCSS checklist is presented which incorporates these new AI-related items. Authors are now expected to disclose AI involvement not only in patient care but also in manuscript preparation, as exemplified by this article. CONCLUSION The STROCSS 2025 guideline provides an up-to-date framework for surgical observational studies in the era of AI. Through a robust consensus STROCSS, we have added specific reporting criteria for AI to ensure that any use of artificial intelligence in a surgical observational study is clearly documented, explained, and discussed including with respect to bias and ethics. This update will help maintain the quality, transparency, and clinical relevance of surgical observational studies, ultimately improving their educational value and trustworthiness for the surgical community.",

keywords = "AI reporting standards, AI transparency and ethics, Artificial intelligence in surgery, Delphi consensus STROCSS, STROCSS guideline update",

author = "Agha, \{Riaz A.\} and Ginimol Mathew and Rasha Rashid and Ahmed Kerwan and Ahmed Al-Jabir and Catrin Sohrabi and Thomas Franchi and Maria Nicola and Maliha Agha and Achilleas Thoma and Alessandro Coppola and Beamish, \{Andrew J.\} and Ashraf Noureldin and Ashwini Rao and Baskaran Vasudevan and Ben Challacombe and Pramesh, \{C. S.\} and Duilio Pagano and Millham, \{Frederick Heaton\} and Gaurav Roy and Huseyin Kadioglu and Nixon, \{Iain James\} and Indraneil Mukherjee and McCaul, \{James Anthony\} and James Ngu and Joerg Albrecht and Rivas, \{Juan Gomez\} and Karanth, \{K. Veena L.\} and Kandiah Raveendran and Ather, \{M. Hammad\} and Thorat, \{Mangesh A.\} and Mohammad Bashashati and Mushtaq Chalkoo and Muensterer, \{Oliver J.\} and Patrick Bradley and Prabudh Goel and Prathamesh Pai and Priya Shinde and Priya Ranganathan and Mohamed, \{Raafat Yahia Afifi\} and Rosin, \{Richard David\} and Roberto Cammarata and Roberto Coppola and Rolf Wynn and Salim Surani and Salvatore Giordano and Samuele Massarut and Raja, \{Shahzad G.\} and Somprakas Basu and Enam, \{Syed Ather\} and Zun, \{Teo Nan\} and Todd Manning and Veeru Kasivisvanathan and \{La Vaccara\}, Vincenzo and Zubing Mei",

note = "Publisher Copyright: {\textcopyright} 2025, The Author(s).",

year = "2025",

month = jul,

doi = "10.70389/PJS.100081",

language = "English (US)",

volume = "10",

journal = "Premier Journal of Science",

issn = "3049-9011",

publisher = "Premier Science",

}

Agha, RA, Mathew, G, Rashid, R, Kerwan, A, Al-Jabir, A, Sohrabi, C, Franchi, T, Nicola, M, Agha, M, Thoma, A, Coppola, A, Beamish, AJ, Noureldin, A, Rao, A, Vasudevan, B, Challacombe, B, Pramesh, CS, Pagano, D, Millham, FH, Roy, G, Kadioglu, H, Nixon, IJ, Mukherjee, I, McCaul, JA, Ngu, J, Albrecht, J, Rivas, JG, Karanth, KVL, Raveendran, K, Ather, MH, Thorat, MA, Bashashati, M, Chalkoo, M, Muensterer, OJ, Bradley, P, Goel, P, Pai, P, Shinde, P, Ranganathan, P, Mohamed, RYA, Rosin, RD, Cammarata, R, Coppola, R, Wynn, R, Surani, S, Giordano, S, Massarut, S, Raja, SG, Basu, S, Enam, SA, Zun, TN, Manning, T, Kasivisvanathan, V, La Vaccara, V & Mei, Z 2025, 'Revised Strengthening the Reporting of Cohort, Cross-Sectional and Case-Control Studies in Surgery (STROCSS) Guideline: An Update for the Age of Artificial Intelligence', Premier Journal of Science, vol. 10, 100081. https://doi.org/10.70389/PJS.100081

TY - JOUR

T1 - Revised Strengthening the Reporting of Cohort, Cross-Sectional and Case-Control Studies in Surgery (STROCSS) Guideline

T2 - An Update for the Age of Artificial Intelligence

AU - Agha, Riaz A.

AU - Mathew, Ginimol

AU - Rashid, Rasha

AU - Kerwan, Ahmed

AU - Al-Jabir, Ahmed

AU - Sohrabi, Catrin

AU - Franchi, Thomas

AU - Nicola, Maria

AU - Agha, Maliha

AU - Thoma, Achilleas

AU - Coppola, Alessandro

AU - Beamish, Andrew J.

AU - Noureldin, Ashraf

AU - Rao, Ashwini

AU - Vasudevan, Baskaran

AU - Challacombe, Ben

AU - Pramesh, C. S.

AU - Pagano, Duilio

AU - Millham, Frederick Heaton

AU - Roy, Gaurav

AU - Kadioglu, Huseyin

AU - Nixon, Iain James

AU - Mukherjee, Indraneil

AU - McCaul, James Anthony

AU - Ngu, James

AU - Albrecht, Joerg

AU - Rivas, Juan Gomez

AU - Karanth, K. Veena L.

AU - Raveendran, Kandiah

AU - Ather, M. Hammad

AU - Thorat, Mangesh A.

AU - Bashashati, Mohammad

AU - Chalkoo, Mushtaq

AU - Muensterer, Oliver J.

AU - Bradley, Patrick

AU - Goel, Prabudh

AU - Pai, Prathamesh

AU - Shinde, Priya

AU - Ranganathan, Priya

AU - Mohamed, Raafat Yahia Afifi

AU - Rosin, Richard David

AU - Cammarata, Roberto

AU - Coppola, Roberto

AU - Wynn, Rolf

AU - Surani, Salim

AU - Giordano, Salvatore

AU - Massarut, Samuele

AU - Raja, Shahzad G.

AU - Basu, Somprakas

AU - Enam, Syed Ather

AU - Zun, Teo Nan

AU - Manning, Todd

AU - Kasivisvanathan, Veeru

AU - La Vaccara, Vincenzo

AU - Mei, Zubing

PY - 2025/7

Y1 - 2025/7

N2 - INTRODUCTION Artificial intelligence (AI) is rapidly transforming healthcare and scientific publishing. Reporting guidelines need to be updated to take into account this advance. The STROCSS Guideline 2025 update adds a new AI-focused domain to promote transparency, reproducibility, and ethical integrity in surgical observational studies involving AI. METHODS A Delphi consensus exercise was conducted to update the STROCSS guidelines. A panel of 49 surgical and scientific experts were invited to rate proposed new items. In Round 1, participants scored each item on a nine-point Likert scale and provided feedback. Items not meeting consensus were revised or discarded. RESULTS A 94% response rate occurred among participants (46/49) in the first round. Ratings were analyzed for agreement levels, and consensus was reached on all six proposed AI-related items. A revised STROCSS checklist is presented which incorporates these new AI-related items. Authors are now expected to disclose AI involvement not only in patient care but also in manuscript preparation, as exemplified by this article. CONCLUSION The STROCSS 2025 guideline provides an up-to-date framework for surgical observational studies in the era of AI. Through a robust consensus STROCSS, we have added specific reporting criteria for AI to ensure that any use of artificial intelligence in a surgical observational study is clearly documented, explained, and discussed including with respect to bias and ethics. This update will help maintain the quality, transparency, and clinical relevance of surgical observational studies, ultimately improving their educational value and trustworthiness for the surgical community.

AB - INTRODUCTION Artificial intelligence (AI) is rapidly transforming healthcare and scientific publishing. Reporting guidelines need to be updated to take into account this advance. The STROCSS Guideline 2025 update adds a new AI-focused domain to promote transparency, reproducibility, and ethical integrity in surgical observational studies involving AI. METHODS A Delphi consensus exercise was conducted to update the STROCSS guidelines. A panel of 49 surgical and scientific experts were invited to rate proposed new items. In Round 1, participants scored each item on a nine-point Likert scale and provided feedback. Items not meeting consensus were revised or discarded. RESULTS A 94% response rate occurred among participants (46/49) in the first round. Ratings were analyzed for agreement levels, and consensus was reached on all six proposed AI-related items. A revised STROCSS checklist is presented which incorporates these new AI-related items. Authors are now expected to disclose AI involvement not only in patient care but also in manuscript preparation, as exemplified by this article. CONCLUSION The STROCSS 2025 guideline provides an up-to-date framework for surgical observational studies in the era of AI. Through a robust consensus STROCSS, we have added specific reporting criteria for AI to ensure that any use of artificial intelligence in a surgical observational study is clearly documented, explained, and discussed including with respect to bias and ethics. This update will help maintain the quality, transparency, and clinical relevance of surgical observational studies, ultimately improving their educational value and trustworthiness for the surgical community.

KW - AI reporting standards

KW - AI transparency and ethics

KW - Artificial intelligence in surgery

KW - Delphi consensus STROCSS

KW - STROCSS guideline update

UR - https://www.scopus.com/pages/publications/105012265370

U2 - 10.70389/PJS.100081

DO - 10.70389/PJS.100081

M3 - Review article

AN - SCOPUS:105012265370

SN - 3049-9011

VL - 10

JO - Premier Journal of Science

JF - Premier Journal of Science

M1 - 100081

ER -

Revised Strengthening the Reporting of Cohort, Cross-Sectional and Case-Control Studies in Surgery (STROCSS) Guideline: An Update for the Age of Artificial Intelligence

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this