The PROCESS 2018 statement: Updating Consensus Preferred Reporting Of CasE Series in Surgery (PROCESS) guidelines

The PROCESS guidelines have since been widely endorsed by a number of journals. The requirement toreport compliance with each item outlined in the PROCESS statement has improved the reporting transparencyof case series across a number of surgical specialties. Here, we undertook a new Delphi consensus exercise toupdate the PROCESS guidelines.Methods: All members of the previous Delphi group were invited to participate. In addition, researchers, editors,and reviewers who have previously published or reviewed case series with the International Journal of Surgerywere invited to collaborate. An online questionnaire was sent to participants asking them to rate their agreementwith amendments to each of the 29 items.Results: 140 experts were invited to participate, 56 people agreed to participate, and 45 (80%) recipientscompleted the survey. There was a high level of agreement amongst the expert group, and unanimous consensuswas reached in the first round. All except three proposed items were accepted, and the original guidelines weremodified accordingly.Conclusion: A modified and improved PROCESS checklist is presented, after a Delphi consensus exercise wascompleted.