Standardised Transparent Orthopaedic Reporting and Modelling for AI (STORM-AI)—Guidelines for reporting artificial intelligence studies in orthopaedics from the ESSKA AI Working Group

Purpose: The rapid growth of Artificial Intelligence (AI) in orthopaedic research has led to inconsistencies in study reporting, hindering evaluation and clinical translation. This initiative aimed to develop the STORM-AI (Standardised Transparent Orthopaedic Reporting and Modelling-AI) guidelines to enhance the transparency, completeness, and quality of reporting for AI studies in orthopaedics. Methods: The ESSKA AI Working Group, a multinational and multidisciplinary team of experts, developed the STORM-AI guidelines through a multi-step consensus process. This involved a comprehensive review of existing AI reporting standards (e.g., CONSORT-AI, STARD-AI and TRIPOD), followed by iterative rounds of drafting, review, and refinement to incorporate orthopaedic-specific considerations. Results: The consensus process resulted in the STORM-AI checklist and an accompanying Explanation and Elaboration (E&E) document. The guidelines provide specific reporting recommendations across all study sections, including study design, data characteristics, model development, performance metrics, ethical considerations and clinical workflow integration. Key areas of emphasis include rigorous validation, clear outcome definition, and error analysis within the orthopaedic context. Conclusion: The STORM-AI guidelines provide a crucial framework for authors, reviewers, and journals to improve the evidence base for AI in orthopaedic care. Widespread adoption is anticipated to foster more robust, reproducible, and clinically valuable innovations, facilitating the responsible integration of AI into orthopaedics. Level of Evidence: Level V.