STROBE

STROBE
Name	STROBE
Caption	Strengthening the Reporting of Observational Studies in Epidemiology
Acronym	STROBE
Established	2004
Purpose	Reporting guideline for observational studies

STROBE

STROBE is a reporting guideline created to improve the transparency, completeness, and reproducibility of observational research. It was developed by a consortium of researchers, methodologists, and journal editors associated with institutions such as World Health Organization, University of Oxford, Harvard University, University of Cambridge, and Johns Hopkins University. The initiative intersects with journal editorial policies from publications like The Lancet, BMJ, JAMA, PLOS Medicine, and Annals of Internal Medicine.

Background

The STROBE initiative emerged amid widespread concern about inconsistent reporting in cohort, case-control, and cross-sectional studies, with discussions at meetings involving representatives from International Committee of Medical Journal Editors, CONSORT, PRISMA, EQUATOR Network, and funders including Wellcome Trust and National Institutes of Health. Early proponents included investigators affiliated with London School of Hygiene and Tropical Medicine, Yale University, Karolinska Institutet, McGill University, and University of Toronto. Workshops and consensus processes paralleled efforts by editorial groups from Nature, Science, and BMJ Group to harmonize standards across observational research reporting.

Purpose and development

The primary purpose is to provide a standardized checklist and explanatory guidance to enhance report clarity for observational epidemiology, addressing deficiencies noted by reviewers at Cochrane Collaboration, Institute of Medicine, and advisory panels at European Centre for Disease Prevention and Control. Development used consensus methodologies similar to those applied by CONSORT for randomized trials and involved experts from Centers for Disease Control and Prevention, US Food and Drug Administration, European Medicines Agency, and academic centers such as Stanford University, University of California, Berkeley, Imperial College London, and University of Sydney. The original publication in 2007 was accompanied by explanatory articles in major journals and follow-up workshops at conferences like International Epidemiological Association and American Public Health Association.

Components and checklist

The STROBE checklist enumerates items for reporting design, methods, results, and interpretation for observational studies, aligning with editorial expectations from The BMJ, The Lancet Oncology, JAMA Internal Medicine, and specialty journals including Circulation, Gastroenterology, Neurology, and Thorax. Checklist elements address title and abstract, background, objectives, study design, setting, participants, variables, data sources, bias, study size, quantitative variables, statistical methods, descriptive data, outcome data, main results, other analyses, limitations, interpretation, and funding; these mirror reporting elements promoted by organizations such as Royal Society, National Academy of Sciences (United States), European Commission, and World Bank. Explanatory documents reference methodological frameworks from Bradford Hill, Austin Bradford Hill, Ronald Fisher, Karl Pearson, and contemporary methodologists at University of Washington, Columbia University, and Duke University.

Application in epidemiological research

STROBE is used by investigators conducting cohort studies such as those from Framingham Heart Study, Nurses' Health Study, Physicians' Health Study, and large registries like SEER Program and UK Biobank; case-control applications include investigations into outbreaks reported by Centers for Disease Control and Prevention and historical analyses linked to Spanish flu and HIV/AIDS research. Cross-sectional studies in public health, surveillance, and policy evaluations adopt STROBE to align with requirements from National Health Service (England), Public Health England, European Centre for Disease Prevention and Control, and national ministries such as Ministry of Health (Brazil), Ministry of Health and Family Welfare (India). Journals including BMJ, PLOS ONE, Nature Communications, and Lancet Global Health often reference the guideline in author instructions and peer-review checklists.

Reporting quality and impact

Empirical assessments by teams at Cochrane Collaboration, EQUATOR Network, Agency for Healthcare Research and Quality, and universities including Oxford, Harvard, and McMaster University have evaluated STROBE’s influence on reporting completeness. Several systematic reviews published in PLOS Medicine, BMJ, Journal of Clinical Epidemiology, and Epidemiology report modest improvements in certain checklist domains but variable uptake across specialties such as Oncology, Cardiology, Nephrology, Psychiatry, and Infectious disease. Editorial policies at Wiley, Elsevier, Springer Nature, and society journals from American Heart Association, American College of Cardiology, and European Society of Cardiology have influenced adherence, as have training programs at Johns Hopkins Bloomberg School of Public Health and London School of Hygiene and Tropical Medicine.

Criticisms and limitations

Critiques from scholars at University of Oxford, University of Sydney, Harvard T.H. Chan School of Public Health, and independent methodologists note that STROBE focuses on reporting rather than study conduct, may be inconsistently enforced by journals like Nature, Science, and some specialty outlets, and can be interpreted variably across fields such as Genetics, Environmental health, Health services research, and Implementation science. Other limitations include incomplete linkage to reporting of causal inference promoted by thinkers associated with Royal Statistical Society, American Statistical Association, Institute for Health Metrics and Evaluation, and methodological movements influenced by Judea Pearl and Donald Rubin. Calls for extensions and updates have led to domain-specific adaptations and proposals from groups at University of Bern, Karolinska Institutet, University of Bristol, and professional societies including International Society for Environmental Epidemiology.

Category:Epidemiology