Observational Study Report Template (STROBE)
Cohort, case-control or cross-sectional report by STROBE topics: variables, bias, OR/RR formulas, adjusted estimates with CI
使い方: Use when reporting a cohort, case-control or cross-sectional study. Pick the design first and define every variable and the confounder set before writing results. Main pitfall: causal language and adjusted estimates without saying which confounders were included and why.
プレビュー
Observational Study Report: [Short title of the study]
Report template for cohort, case-control and cross-sectional studies. The sections follow the topics of the STROBE Statement (title and abstract, introduction, methods, results, discussion, other information), written in original words for this collection. Use it with the official STROBE checklist for your design from strobe-statement.org. This is a reporting format, not clinical, epidemiological or statistical advice. Replace every
[bracketed]value and every row marked Example.
Document control
| Field | Value |
|---|---|
| Document ID | [OBS-STUDY-001] |
| Study design | [Cohort / Case-control / Cross-sectional] |
| Protocol or registration | [Registry, OSF link or "not registered"] |
| Ethics reference | [REC / IRB number or exemption] |
| Version | [0.1] |
| Status | [Draft / In review / Approved] |
| Owner | [@principal-investigator] |
| Approvers | [@study-statistician], [@co-investigator] |
| Last updated | YYYY-MM-DD |
| Classification | [Confidential until publication] |
Approvals
| Role | Name | Decision | Date |
|---|---|---|---|
| Principal investigator | [@name] | [Approved] | YYYY-MM-DD |
| Study statistician | [@name] | [Approved] | YYYY-MM-DD |
| Data custodian | [@name] | [Approved for release of aggregate results] | YYYY-MM-DD |
Revision history
| Version | Date | Author | Change summary |
|---|---|---|---|
| 0.1 | YYYY-MM-DD | [@name] | First draft after analysis |
| 0.2 | YYYY-MM-DD | [@name] | Example: Added E-value sensitivity analysis for unmeasured confounding |
| 1.0 | YYYY-MM-DD | [@name] | Approved for submission |
Contents
1. Title and abstract
The title states the design; the abstract gives an informative, balanced summary.
Title: [Exposure] and [outcome] in [population]: a [prospective cohort / population-based case-control / cross-sectional] study
| Heading | Content |
|---|---|
| Objective | [Research question in one sentence] |
| Design and setting | [Design, data source, country, years] |
| Participants | [Who and how many] |
| Exposure and outcome | [Definitions in brief] |
| Results | Example: Among 18,240 adults followed for a median 6.1 years, 1,032 developed [outcome]. The adjusted hazard ratio for [exposure] was 1.34 (95% CI 1.15 to 1.56). |
| Conclusions | [Interpretation proportionate to the design] |
2. Introduction
The introduction explains the background and states what the study set out to find.
2.1 Background and rationale
[Summarise what is known about the exposure-outcome relationship, the gaps or inconsistencies in the evidence and why an observational design is appropriate.]
2.2 Objectives
| ID | Objective | Pre-specified hypothesis |
|---|---|---|
| OBJ-01 | Example: Estimate the association between [exposure] and incident [outcome] | Higher exposure is associated with higher risk |
| OBJ-02 | [Secondary objective] | [Hypothesis or "exploratory"] |
3. Methods
This section explains how the study was designed and analysed.
3.1 Study design
[State the design and its key elements, for example: prospective cohort nested within [cohort name], with exposure measured at baseline and outcome ascertained through linkage to [registry].]
The design determines which measures and checklist items apply:
| Design | Participants sampled by | Typical measure | Key validity question |
|---|---|---|---|
| Cohort | Exposure status, then followed for outcome | Risk ratio, rate ratio, hazard ratio | Was follow-up complete and similar across exposure groups? |
| Case-control | Outcome status, then exposure measured | Odds ratio | Do controls represent the population that produced the cases? |
| Cross-sectional | Neither; one point in time | Prevalence, prevalence ratio, odds ratio | Can the order of exposure and outcome be established? |
3.2 Setting
| Item | Detail |
|---|---|
| Location | [Country, region, facilities] |
| Recruitment period | YYYY-MM-DD to YYYY-MM-DD |
| Exposure assessment period | [Dates] |
| Follow-up period | Example: From baseline until outcome, death, emigration or 2024-12-31, whichever came first |
| Data collection | [Dates] |
3.3 Participants
| Design | Item | Detail |
|---|---|---|
| Cohort | Eligibility, sources and selection | [Criteria and methods] |
| Cohort | Follow-up methods | [Active follow-up, linkage] |
| Cohort (matched) | Matching criteria, number exposed and unexposed | [Criteria] |
| Case-control | Case ascertainment and diagnosis | [Definition and source] |
| Case-control | Control selection and rationale | Example: Four population controls per case, matched on age (+/- 2 years), sex and region, sampled by incidence density |
| Cross-sectional | Eligibility, sources and selection | [Criteria and sampling frame] |
3.4 Variables
| ID | Variable | Role | Definition | Type |
|---|---|---|---|---|
| VAR-01 | Example: Incident type 2 diabetes | Outcome | First diagnosis code [codes] or HbA1c of at least 48 mmol/mol | Time to event |
| VAR-02 | [Exposure] | Exposure | [Definition, categories] | [Categorical] |
| VAR-03 | Age | Confounder | Years at baseline | Continuous |
| VAR-04 | [Smoking status] | Confounder | [Never / former / current] | Categorical |
| VAR-05 | [Sex] | Effect modifier | [Recorded sex] | Binary |
A directed acyclic graph helps justify the confounder set:
3.5 Data sources and measurement
| Variable | Source | Measurement method | Comparability across groups |
|---|---|---|---|
| [Exposure] | [Questionnaire / records / biomarker] | [Instrument, validation reference] | [Same method for all] |
| [Outcome] | [Registry / adjudication] | [Coding system, adjudication process] | Example: Adjudicators blind to exposure status |
| [Confounder] | [Source] | [Method] | [Comment] |
3.6 Bias
| Bias | How it could arise | Mitigation | Likely direction if residual |
|---|---|---|---|
| Selection bias | [Healthy volunteer effect] | [Population-based sampling] | [Towards null] |
| Information bias | Example: Recall of exposure differs between cases and controls | Exposure taken from records made before diagnosis | Not applicable |
| Confounding | [Unmeasured lifestyle factors] | [Adjustment; E-value] | [Away from null] |
| Loss to follow-up | [Differential attrition] | [Linkage-based follow-up] | [Unclear] |
3.7 Study size
[Explain how the size was determined. For example: all eligible members of the cohort were included; with an expected 1,000 events, the study could detect a hazard ratio of 1.20 with 80% power at a two-sided alpha of 0.05.]
3.8 Quantitative variables
| Variable | Handling | Rationale |
|---|---|---|
| [Age] | Example: Restricted cubic spline with 4 knots | Non-linear relationship expected |
| [Exposure] | [Quartiles of the distribution in controls] | [Rationale] |
| [Body mass index] | [WHO categories] | [Clinical convention] |
3.9 Statistical methods
The measures of association used depend on design. From a 2 x 2 table with exposed cases , exposed non-cases , unexposed cases and unexposed non-cases :
The 95% confidence interval for the odds ratio (Woolf method) is:
| Item | Method |
|---|---|
| Main model | Example: Cox proportional hazards with age as the time scale; proportional hazards checked with Schoenfeld residuals |
| Confounder adjustment | [Covariates chosen from the DAG in 3.4] |
| Subgroups and interactions | [Pre-specified; likelihood ratio test] |
| Missing data | [Multiple imputation by chained equations, 20 data sets] |
| Loss to follow-up / matching | [Censoring rules; conditional logistic regression for matched sets] |
| Survey sampling | [Weights, strata, clusters for cross-sectional surveys] |
| Sensitivity analyses | [Complete case; excluding first 2 years of follow-up; E-value] |
| Software | [R / Stata / SAS version] |
4. Results
This section reports who was studied and what was found.
4.1 Participants
The flow diagram shows numbers at each stage of the study.
| Stage | n | Reasons for exclusion or non-participation |
|---|---|---|
| Potentially eligible | [24,105] | |
| Excluded | [5,865] | Example: 3,210 prevalent outcome at baseline; 1,904 missing exposure; 751 declined |
| Included | [18,240] | |
| Analysed | [17,828] | [Reasons] |
4.2 Descriptive data
| Characteristic | Exposed (n = [x]) | Unexposed (n = [y]) | Missing, n |
|---|---|---|---|
| Age, years, mean (SD) | Example: 57.3 (8.9) | 55.1 (9.4) | 0 |
| Female, n (%) | [Value] | [Value] | [0] |
| Current smoker, n (%) | [Value] | [Value] | [214] |
| [Confounder] | [Value] | [Value] | [n] |
Follow-up: [median (IQR) years and total person-years].
4.3 Outcome data
| Group | Events / participants | Person-years | Rate per 1,000 person-years |
|---|---|---|---|
| Exposed | Example: 612 / 8,904 | 53,420 | 11.5 |
| Unexposed | 420 / 8,924 | 55,310 | 7.6 |
4.4 Main results
| Model | Estimate (95% CI) | Adjusted for |
|---|---|---|
| Unadjusted | Example: HR 1.52 (1.34 to 1.73) | None |
| Model 1 | HR 1.41 (1.24 to 1.61) | Age, sex |
| Model 2 (main) | HR 1.34 (1.15 to 1.56) | Model 1 plus smoking, socioeconomic status, [others] |
Category boundaries for categorised continuous variables: [list]. Absolute risk difference over [10 years]: [value (95% CI)].
4.5 Other analyses
| Analysis | Pre-specified? | Result | Comment |
|---|---|---|---|
| By sex | Yes | [HR women 1.29; men 1.40; interaction P = 0.52] | No effect modification |
| Excluding first 2 years | Yes | [HR 1.31 (1.11 to 1.54)] | Reverse causation unlikely |
| E-value for main estimate | No | [2.02] | [Interpretation] |
5. Discussion
The discussion interprets the findings with appropriate caution.
5.1 Key results
[Summarise the main findings with reference to the study objectives.]
Example: In this population-based cohort, adults with [exposure] had a 34% higher adjusted rate of [outcome] than those without, corresponding to about 3.9 additional cases per 1,000 person-years. The association was consistent across sex and age groups and persisted after excluding the first two years of follow-up.
5.2 Limitations
- [Source of potential bias or imprecision, its likely direction and magnitude]
- [Residual and unmeasured confounding]
- [Measurement error in exposure, for example a single baseline measurement that may not reflect long-term exposure, which usually biases estimates towards the null]
- [Missing data and the plausibility of the missing-at-random assumption]
- [Multiple comparisons across secondary outcomes and subgroups]
For each limitation, state whether it is likely to have inflated or attenuated the main estimate and, where possible, by how much. A quantitative bias analysis or an E-value is more informative than a general statement that confounding cannot be excluded.
5.3 Interpretation
[Give a cautious overall interpretation considering objectives, limitations, multiplicity of analyses, results from similar studies and other relevant evidence. Avoid causal language unless justified.]
5.4 Generalisability
[Discuss the external validity of the results: to which populations and settings they apply.]
Consider how the study population differs from the target population in age, ethnicity, healthcare access and baseline risk; whether the exposure definition matches how the exposure occurs in practice; and whether the calendar period of the study still reflects current care. Distinguish between transporting a relative effect, which may hold across settings, and an absolute effect, which depends on local baseline risk.
6. Other information
Transparency information for readers:
| Item | Detail |
|---|---|
| Funding | [Funder, grant number] |
| Role of funder | [Role in design, analysis, interpretation, publication, or none] |
| Original study funding | [If the present article is based on an earlier study] |
| Ethics | [Approval reference, consent or waiver] |
| Data availability | [Access route, conditions, governance] |
| Code availability | [Repository link] |
| Conflicts of interest | [Statement] |
7. Appendices
Supporting material for reviewers:
| Appendix | Content |
|---|---|
| A | Completed STROBE checklist for the design, with page numbers |
| B | Code lists for exposure, outcome and covariates |
| C | Full model output and sensitivity analyses |
| D | Glossary: [CI confidence interval, DAG directed acyclic graph, HR hazard ratio, OR odds ratio, RR relative risk] |
Standard and licence note
Based on the STROBE Statement: von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, for the STROBE Initiative, The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies (PLoS Med 2007;4(10):e296 and parallel publications), https://www.strobe-statement.org. The checklists are published open access; this template uses their item topics only, paraphrased in original text, and reproduces no checklist wording. Use the official checklist for your design when submitting. This is a reporting format, not clinical, epidemiological or statistical advice. Template licence: MIT.
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