Improving social justice in observational studies
STROBE Equity Extension
What is the motivation for the extension of STROBE for Equity? Health inequities can go frequently unreported in observational studies. This international group of scientists, educators, decision-makers, ethicists, funders, and patients, using an integrated knowledge translation approach, proposes to develop an extension to the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guideline to deal specifically with these disparities.
What is the purpose of the extension of STROBE for equity? The objective of this study is to develop guidelines to improve the reporting of health equity considerations in observational studies. The equity extension supplements the original core STROBE. Extensions of the STROBE Statement have been developed to give additional guidance for observational studies with specific designs, data and interventions, and which in this case are focused on equity.
What is the name of the STROBE extension for Equity? The name of the extended version of STROBE for equity is "STROBE-Equity Extension".
How were the candidate checklist items developed? The candidate items presented in this survey were developed from a scoping review of available guidance, a methodological survey of a random sample of observational studies, and through discussions with experts on the STROBE Equity Executive and Advisory Board. Both international groups and membership are listed here.
Who will use the STROBE extension for Equity? For the same reason that people use STROBE, people who have conducted observational studies that build evidence that is relevant to equity, or "equity-relevant observational studies" will use the extension, as well as those wanting to see how the observational studies are reported. In addition, this extension of STROBE for Equity can be used with other STROBE extensions. The STROBE Equity extension will be made publicly available on the Cochrane and Campbell equity methods group website.
How is this global survey contributing to the development of the STROBE-Equity extension? This is the first step to collect broad feedback on our initial proposed items. The next step will be a modified Delphi process with a small multidisciplinary group of stakeholders. A Delphi process is a method for generating consensus or feedback from a group of individuals on a topic using a process in a manner that is inclusive. It is particularly useful when there are a larger number of participants who are not able to have a face-to-face meeting and when a solution can best be determined through subjective opinions of a group of individuals (as opposed to analytically for example). Your input on this survey is extremely valuable and we welcome you to share it with friends and colleagues
For more information, please refer to the study protocol: Improving social justice in observational studies: protocol for the development of a global and Indigenous STROBE-equity reporting guideline.
PUBLICATIONS
Dewidar O, Al-Zubaidi A, Bondok M, Abdelrazeq L, Huang J, Jearvis A, Barker LV, et al. Reporting of equity in observational epidemiology: A methodological review. J Glob Health. 2024;14:04046.
Funnell S, Jull J, Mbuagbaw L, Welch V, Dewidar O, Wang X, Lesperance M, et al. Improving social justice in observational studies: protocol for the development of a global and Indigenous STROBE-equity reporting guideline. Int J Equity Health. 2023;22(1):55.
Wang X, Dewidar O, Rizvi A, Huang J, Desai P, Doyle R, et al. A scoping review establishes need for consensus guidance on reporting health equity in observational studies. Journal of Clinical Epidemiology. 2023;160:126-140.
DEFINITIONS
Term | Definition |
| Health equity | Health equity is defined as the absence of avoidable and unfair differences in health within and between populations. Observational studies are conducted in real-world settings and are well suited for understanding the distribution of health inequities and monitoring changes in the policy over time. We use the term ‘populations experiencing inequities’ to describe populations who are denied opportunities that others have to benefit from social and environmental conditions that lead to better health. Commitment to health equity is about improving health outcomes for people who experience socially-structured disadvantage and as a result, are not able to achieve their optimal health status. We use the acronym PROGRESS Plus.
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Observational studies | Observational studies are analytical or descriptive studies evaluating a research question without changing exposure to an intervention. Observational studies are classified in the STROBE reporting guideline into three types:
Studies conducted using routinely collected data stored in administrative datasets can be classified into these three types of studies. |
Health equity-relevant observational studies | Health equity-relevant observational studies either include only populations experiencing inequities or conduct disaggregated analyses to assess if outcomes differ for different population sub-groups. These studies assess the effects of the intervention or the exposure on the health of a group and/or population that experiences socially structured health disadvantage (across PROGRESS). The studies can be categorized as one of the following two types:
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Context | Context reflects a set of characteristics and circumstances that consist of active and unique factors, within which the implementation is embedded (Pfadenhauer, 2015). It could exist in eight domains: locational, geographical, epidemiological, sociocultural, socioeconomic, ethical, legal and political. |
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CIHR-funded, 4 year project led by Drs Vivian Welch, Sarah Funnell, Janet E Jull, and Lawrence C Mbuagbaw to develop an equity extension of the STROBE reporting guideline for observational studies.
Health inequities can go frequently unreported in observational studies. This international group of scientists, educators, decision-makers, ethicists, funders, and patients, using an integrated knowledge translation approach, proposes to develop an extension to the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) guideline to deal specifically with these disparities. The project will embed a parallel stream focused on evidence related to Indigenous research. After assessing available guidance for reporting health equity in observational studies and assessing current reporting, they plan to seek international feedback, then conduct an evidence and consensus-driven process to develop a reporting guideline. The project started in January 2021. A series of empirical studies are planned, followed by a consensus meeting, with the final reporting guideline and statement expected in 2024.
See all the project details on the Open Science Framework.
STROBE-Equity Extension on the EQUATOR website