Use to select and apply the correct EQUATOR reporting guideline for a Lancet manuscript — CONSORT for RCTs (with the mandatory flow diagram), STROBE for observational studies, PRISMA for systematic reviews/meta-analyses, SPIRIT for protocols — and to attach the completed checklist and study-flow diagram.
Use to select and apply the correct EQUATOR reporting guideline for a Lancet manuscript — CONSORT for RCTs (with the mandatory flow diagram), STROBE for observational studies, PRISMA for systematic reviews/meta-analyses, SPIRIT for protocols — and to attach the completed checklist and study-flow diagram.
The flow diagram is mandatory for RCTs and systematic reviews
CONSORT flow diagram present for every RCT: numbers assessed for eligibility, excluded (with reasons), randomized, allocated, lost to follow-up/discontinued (with reasons), and analyzed in each arm.
PRISMA flow diagram present for every systematic review/meta-analysis: records identified, duplicates removed, screened, full-text assessed, excluded (with reasons), and included.
Every number in the flow diagram reconciles with Table 1, the analysis populations, and the abstract.
Checklist discipline
Complete the official checklist for the chosen guideline.
Map each item to a page and line in the manuscript (editors and reviewers check this).
Use the correct extension (e.g., CONSORT cluster for cluster-randomized trials; CONSORT harms for adverse-event reporting; CONSORT-PRO for patient-reported outcomes).
Submit the checklist as a supplementary file.
Equity-relevant reporting
Apply equity-focused extensions where relevant (e.g., PRISMA-Equity, CONSORT-Equity considerations) and the PROGRESS-Plus framework for reporting equity-relevant participant characteristics.
Coordinate sex/gender and race/ethnicity reporting with lancet-ethics (SAGER guidelines).
What Lancet editors and reviewers expect from reporting compliance
A completed checklist is a screening gate at The Lancet, not a formality. Editors and the statistical reviewer cross-read the flow diagram against Table 1 and the analysis populations; a discrepancy reads as a transcription error or selective reporting, and unexplained attrition is where bias hides. Desk-reject-adjacent patterns: no flow diagram for an RCT or review (effectively mandatory); base CONSORT where a cluster/non-inferiority extension fits; a checklist that says "throughout" instead of page/line; and numbers that do not reconcile. Confirm any current formatting requirement against the journal's author guidelines.
Worked micro-example (illustrative numbers — not real data)
A hypothetical multi-country, individually randomised trial of an oral therapy versus placebo across 14 sites in 5 low- and middle-income countries.
The reporting pass is the reconciliation: 4 204 appears identically in the diagram, Table 1, and the abstract, and every exclusion and dropout carries a reason.
Reviewer-pushback patterns and the venue-specific fix
"The reporting checklist is incomplete / not page-referenced." → Complete the official EQUATOR checklist and map each item to a page and line; resubmit as a supplement.
"This is a cluster-randomised trial but reported under standard CONSORT." → Switch to CONSORT-Cluster with cluster-level flow and intracluster correlation reporting.
"Flow-diagram numbers do not match the analysis populations." → Rebuild the diagram so randomised, analysed, and Table 1 totals reconcile; explain any gap.
"Equity-relevant characteristics are not reported." → Add PROGRESS-Plus variables and a PRISMA-Equity/CONSORT-Equity lens; coordinate with lancet-ethics.
