Agent Skills: STROBE Compliance Checker

Use when auditing an observational study manuscript (cohort, case-control, or cross-sectional) against the STROBE checklist. Triggers on retrospective studies, hospital data, registry/database studies like TCGA, SEER, NHIRD, or any non-randomized clinical research.

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Skill Metadata

Name
strobe-check
Description
Use when auditing an observational study manuscript (cohort, case-control, or cross-sectional) against the STROBE checklist. Triggers on retrospective studies, hospital data, registry/database studies like TCGA, SEER, NHIRD, or any non-randomized clinical research.

STROBE Compliance Checker

Audit observational study manuscripts against the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) 22-item checklist.

Workflow

  1. Read the full manuscript
  2. Identify the study design: cohort, case-control, or cross-sectional
  3. Walk through each item below, noting design-specific sub-items
  4. For each item, assign: Reported / Partial / Missing / N/A
  5. Quote the relevant manuscript text (with line/page reference) as evidence
  6. Output a compliance summary table + actionable fixes for Missing/Partial items

STROBE Checklist (22 Items)

Title and Abstract

| # | Topic | Requirement | |---|-------|-------------| | 1a | Title | Indicate the study design with a commonly used term in the title or abstract | | 1b | Abstract | Provide an informative and balanced summary of what was done and found |

Introduction

| # | Topic | Requirement | |---|-------|-------------| | 2 | Background/rationale | Explain the scientific background and rationale for the investigation | | 3 | Objectives | State specific objectives, including any prespecified hypotheses |

Methods

| # | Topic | Requirement | |---|-------|-------------| | 4 | Study design | Present key elements of study design early in the paper | | 5 | Setting | Describe setting, locations, relevant dates (recruitment, exposure, follow-up, data collection) | | 6a | Participants | Cohort: eligibility criteria, sources/methods of selection, methods of follow-up. Case-control: eligibility, case ascertainment, control selection, rationale. Cross-sectional: eligibility, sources/methods of selection | | 6b | Participants | Cohort/Case-control: For matched studies, give matching criteria and number matched | | 7 | Variables | Clearly define all outcomes, exposures, predictors, confounders, effect modifiers; give diagnostic criteria | | 8 | Data sources | For each variable, give sources of data and methods of assessment; describe comparability across groups | | 9 | Bias | Describe any efforts to address potential sources of bias | | 10 | Study size | Explain how the study size was arrived at | | 11 | Quantitative variables | Explain how quantitative variables were handled; describe groupings and rationale | | 12a | Statistical methods | Describe all statistical methods, including confounding control | | 12b | Statistical methods | Methods for subgroups and interactions | | 12c | Statistical methods | How missing data were addressed | | 12d | Statistical methods | Cohort: how loss to follow-up was addressed. Case-control: how matching was addressed. Cross-sectional: sampling strategy methods | | 12e | Statistical methods | Describe any sensitivity analyses |

Results

| # | Topic | Requirement | |---|-------|-------------| | 13a | Participants | Report numbers at each stage of study (eligible, examined, confirmed, included, completed, analysed) | | 13b | Participants | Give reasons for non-participation at each stage | | 13c | Participants | Consider use of a flow diagram | | 14a | Descriptive data | Characteristics of participants (demographic, clinical, social) and information on exposures/confounders | | 14b | Descriptive data | Number of participants with missing data for each variable | | 14c | Descriptive data | Cohort: Summarise follow-up time (average and total) | | 15 | Outcome data | Cohort: numbers of outcome events or summary measures over time. Case-control: numbers in each exposure category. Cross-sectional: numbers of outcome events or summary measures | | 16a | Main results | Unadjusted estimates and confounder-adjusted estimates with precision (95% CI). State which confounders and why | | 16b | Main results | Report category boundaries when continuous variables were categorised | | 16c | Main results | If relevant, translate relative risk into absolute risk for a meaningful time period | | 17 | Other analyses | Report subgroup analyses, interactions, sensitivity analyses |

Discussion

| # | Topic | Requirement | |---|-------|-------------| | 18 | Key results | Summarise key results with reference to study objectives | | 19 | Limitations | Discuss limitations: sources of bias/imprecision, direction and magnitude of potential bias | | 20 | Interpretation | Cautious overall interpretation considering objectives, limitations, multiplicity, similar studies | | 21 | Generalisability | Discuss external validity of results |

Other Information

| # | Topic | Requirement | |---|-------|-------------| | 22 | Funding | Source of funding and role of funders |

Design-Specific Attention

| Design | Extra Focus | |--------|-------------| | Cohort | Items 6b, 12d (follow-up), 14c (follow-up time), 15 (events over time) | | Case-control | Items 6a-6b (case/control selection rationale, matching), 12d (matching analysis), 15 (exposure categories) | | Cross-sectional | Items 6a (selection), 12d (sampling strategy), 15 (summary measures) |

Common STROBE Gaps

| Frequently Missing | Fix | |--------------------|-----| | Item 9 (Bias) | Add a dedicated paragraph on bias sources and mitigation strategies | | Item 10 (Study size) | State sample size justification or explain it was convenience-based | | Item 12c (Missing data) | Describe complete-case, imputation, or sensitivity approach | | Item 14b (Missing data counts) | Add missingness counts per variable to Table 1 or supplement | | Item 16a (Unadjusted + adjusted) | Report both crude and adjusted estimates with 95% CIs | | Item 19 (Limitations direction) | Discuss direction of bias (toward/away from null), not just list weaknesses |

Output Format

STROBE Compliance Report
Study design: [Cohort / Case-control / Cross-sectional]
Manuscript: [filename]

Summary: X/22 Reported | Y Partial | Z Missing | W N/A

MISSING ITEMS (priority fixes):
  [Item #] [Topic] — [What's needed]

PARTIAL ITEMS (improvements needed):
  [Item #] [Topic] — [What's present] → [What's missing]

FULLY REPORTED:
  [Item #] [Topic] ✓

Extensions

  • STROBE-Equity (2024): 10 additional items for reporting health equity data. Use alongside core STROBE when the study addresses health disparities.
  • RECORD (REporting of studies Conducted using Observational Routinely-collected Data): Extension for electronic health record / claims database studies.

Related Skills

  • /manuscript — Overall manuscript writing and anti-pattern scanning
  • /human-write — AI-flavored vocabulary detection