Riaz A. Agha1 
, Ginimol Mathew2 , Rasha Rashid3 , Ahmed Kerwan4 , Ahmed Al-Jabir5 , Catrin Sohrabi2 , Thomas Franchi6 , Maria Nicola7 , Maliha Agha1
- Premier Science, London, UK
- Royal Free London NHS Foundation Trust, London, UK
- Imperial College School of Medicine, London, UK
- Harvard T.H. Chan School of Public Health, Boston, USA
- University College London Hospital, London, UK
- Wellington Regional Hospital, Te Whatu Ora Capital Coast and Hutt Valley, Wellington, New Zealand
- Imperial College London, London, UK
Correspondence to: Riaz Agha, Premier Science riaz@premierscience.com
Additional information
- Ethical approval: N/a
- Consent: N/a
- Funding: None
- Conflicts of interest: The authors have no financial, consultative, institutional, or other relationships that might lead to bias or a conflict of interest.
- Author contribution: R.A.A.: conceptualisation, manuscript drafting and critical revision, approval of the final manuscript. A.K., A.A.-J., C.S., T.F., G.M., M.N., R.R., M.A. R.A.A: contribution to drafting, manuscript writing and revision, approval of the final manuscript.
- Guarantor: Riaz A Agha
- Provenance and peer-review:
Unsolicited and externally peer-reviewed - Data availability statement: The Delphi survey data that informed this guideline (individual expert ratings and comments) are confidential and not publicly available, in accordance with the consensus process protocol. All relevant aggregated results are reported in this article.
Keywords: artificial intelligence, reporting guidelines, scare process strocss titan, ai transparency, delphi consensus.
Peer Review
Received: 22 May 2025
Revised: 23 May 2025
Accepted: 23 May 2025
Published: 23 May 2025
“Can machines think?” – this is the question posed by Alan Turing in 1950 in his classic paper.1 In the years that followed the term artificial intelligence (AI) was adopted and the field was formally born at the Dartmouth Summer research project on AI.2 More recently AI has been thrust into the forefront of public consciousness via the media and a market valuation of $638bn in 2024.3 This is projected to further increase (see figure 1) and PwC’s Global Artificial Intelligence Study values the potential contribution to the global economy by 2030 from AI at $15.7tr.4
Source: Precedence Research.
The reporting quality of the published literature has long been a source of angst amongst readers.5,6,7,8,9 Reporting guidelines have had a major impact on the reporting quality of the published literature.10,11 They can help authors to plan their work, to write papers and act as a guide but they can also be used to set standards and expectations – all stakeholders benefit from good reporting. Indeed, reviewers and editors can spend more time focussing on what’s present than what’s missing and there is markedly less friction and frustration for readers as well. The scholarly community recognises their importance and adoption has been widespread.
Recognising the above, we now update the SCARE, PROCESS and STROCSS guidelines for 202512,13,14,15 with a new section on AI. We also develop the new mini-guideline TITAN to help provide AI transparency for other article types. This update already seems overdue given the speed at which AI is developing. We know many authors are already using it, now is the time to declare such usage, be transparent and detail how, what, when and why it was used. This additional block has gone through researcher group development, extensive discussion and a Delphi consensus exercise with a broad and multidisciplinary group of experts in the field. In keeping with this update, we can also declare that AI was used to help generate ideas for guideline development and indeed the addition of AI was itself recommended. We commend the adoption of these guidelines and hope they are well received by the scholarly and surgical communities.
References
1. Turing, A.M. (1950). Computing machinery and intelligence. Mind, 59, 433-460.
2. Datmouth College, Artificial Intelligence Coined at Dartmouth [online]. Available at: https://home.dartmouth.edu/about/artificial-intelligence-ai-coined-dartmouth (Accessed 17th May 2025)
3. Precedence Research. Artificial Intelligence (AI) Market Size, Share, and Trends 2025 to 2034 [online]. Available at: https://www.precedenceresearch.com/artificial-intelligence-market (accessed 17th May 2025).
4. PwC. PwC’s Global Artificial Intelligence Study: Exploiting the AI Revolution [online], available at: https://www.pwc.com/gx/en/issues/artificial-intelligence/publications/artificial-intelligence-study.html (Accessed 17th May 2025).
5. Agha R, Fowler A, Lee S, Gundogan B, Whitehurst B, Sagoo H, Jeong KJL, Altman D and Orgill D. A Systematic Review of the Methodological and Reporting Quality of Case Series in Surgery. British Journal of Surgery 2016;103(10):1253-8.
6. Agha R, Lee S, Jeong KJL, Fowler A and Orgill DP. Reporting Quality of Observational Studies in Plastic Surgery Needs Improvement: A Systematic Review. Annals of Plastic Surgery 2016;76(5):585-9.
7. Agha RA, Camm CF, Doganay E, Edison E, Siddiqui MRS and Orgill DP. Randomised Controlled Trials in Plastic Surgery: A Systematic Review of Reporting Quality. European Journal of Plastic Surgery 2013;37:55-62.
8. Lee SY, Sagoo H, Whitehurst K, Wellstead G, Fowler A, Agha RA and Orgill DP. The Reporting Quality of Systematic Reviews in Plastic Surgery Needs Improvement: A Systematic Review. JAMA Facial Plastic Surgery 2015;17:1-5.
9. Yao A, Khajuria A, Camm C, Edison E and Agha R. The Reporting Quality of Parallel Randomised Controlled Trials in Ophthalmic Surgery in 2011: A Systematic Review. EYE 2014;28(11):1341-9.
10. Agha RA, Farwana R, Borrelli MR, Kusu-Orkar T, Millip MC, Thavayogan R, Garner J, Tickunas T, and Orgill DP. Impact of SCARE Guideline on the reporting of surgical case reports: A Before and After Study. International Journal of Surgery 2017;45:144-148.
11. Agha RA, Borrelli MR, Farwana R, Kusu-Orkar T, Millip MC, Thavayogan R, Garner J, Darhouse N, and Orgill DP. Impact of the PROCESS Guideline on the reporting of surgical case series: A before and after study. International Journal of Surgery 2017;45:92-97.
12. Ahmed Kerwan, Ahmed Al-Jabir, Ginimol Mathew, Catrin Sohrabi, Rasha Rashid, Thomas Franchi, Maria Nicola, Maliha Agha, Riaz A. Agha. Revised Surgical CAse REport (SCARE) guideline: An update for the age of Artificial Intelligence. Premier Journal of Science 2025:10;100079
13. Agha RA, Mathew G, Rashid R, Kerwan A, Al-Jabir A, Sohrabi C, Franchi T, Nicola M, Agha M. Revised Preferred Reporting of Case Series in Surgery (PROCESS) Guideline: An update for the age of Artificial Intelligence. Premier Journal of Science 2025:10;100080
14. Agha RA, Mathew G, Rashid R, Kerwan A, Al-Jabir A, Sohrabi C, Franchi T, Nicola M, Agha M. 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 2025:10;100081.
15. Agha RA, Mathew G, Rashid R,Kerwan A, Al-Jabir A, Sohrabi C, Franchi T, Nicola M, Agha M. Transparency In The reporting of Artificial INtelligence– the TITAN guideline. Premier Journal of Science 2025:10;100082.
Cite this article as:
Agha RA, Mathew G, Rashid R, Kerwan A, Al-Jabir A, Sohrabi C, Franchi T, Nicola M, Agha M. Updated Reporting Guidelines in the age of Artificial Intelligence: SCARE, PROCESS, STROCSS and TITAN 2025. Premier Journal of Science 2025:10;100083
