Uses and misuses of the STROBE statement: bibliographic study

<jats:sec><jats:title>Objectives</jats:title><jats:p>Appropriate reporting is central to the application of findings from research to clinical practice. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) recommendations consist of a checklist of 22 items that provide guidance on the reporting of cohort, case–control and cross-sectional studies, in order to facilitate critical appraisal and interpretation of results. STROBE was published in October 2007 in several journals including<jats:italic>The Lancet</jats:italic>,<jats:italic>BMJ</jats:italic>,<jats:italic>Annals of Internal Medicine</jats:italic>and<jats:italic>PLoS Medicine</jats:italic>. Within the framework of the revision of the STROBE recommendations, the authors examined the context and circumstances in which the STROBE statement was used in the past.</jats:p></jats:sec><jats:sec><jats:title>Design</jats:title><jats:p>The authors searched the Web of Science database in August 2010 for articles which cited STROBE and examined a random sample of 100 articles using a standardised, piloted data extraction form. The use of STROBE in observational studies and systematic reviews (including meta-analyses) was classified as appropriate or inappropriate. The use of STROBE to guide the reporting of observational studies was considered appropriate. Inappropriate uses included the use of STROBE as a tool to assess the methodological quality of studies or as a guideline on how to design and conduct studies.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The authors identified 640 articles that cited STROBE. In the random sample of 100 articles, about half were observational studies (32%) or systematic reviews (19%). Comments, editorials and letters accounted for 15%, methodological articles for 8%, and recommendations and narrative reviews for 26% of articles. Of the 32 observational studies, 26 (81%) made appropriate use of STROBE, and three uses (10%) were considered inappropriate. Among 19 systematic reviews, 10 (53%) used STROBE inappropriately as a tool to assess study quality.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The STROBE reporting recommendations are frequently used inappropriately in systematic reviews and meta-analyses as an instrument to assess the methodological quality of observational studies.</jats:p></jats:sec>