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Continuing use of the terms prospective and retrospective and quality of reporting of observational studies: time to update the STROBE guideline?

but not in the title; 13 (9%) papers used the terms exclusively in the abstract; and 31 (21%) exclusively in the methods section. The terms were never used exclusively in the title; 55 of the papers (37%) used the term in the title or abstract, and this proportion is 5% higher than the proportion observed in PubMed [95% confidence interval (CI): -3% to 13%]. Of the 150, 73 papers (49%) used the terms prospective or retrospective in the methods sections. Twelve papers (8%) used the terms in the title and 53 (35%) in the abstract (Figure 2). ‘Prospective’ was used 2.2 (95% CI: 1.5 to 3.2) times more often for reports of all study designs than ‘retrospective’. Papers published in general epidemiology journals used the terms less than papers published in clinical specialist and general medicine journals. Also, the terms were used more to describe cohort studies than case-control and cross-sectional studies. The use of the terms ‘retrospective’ and ‘prospective’, however, is not associated with the overall quality of the report as measured as STROBE adherence score or in any of its domains (Setting, Participants, Variables, Data sources/ measurement and Bias). Again, no differences in quality of the report were observed according to papers using the terms or not, study type, journal recommending STROBE, journal type or impact factor (for detailed results see Appendix 3, available as Supplementary data at IJE online). In summary, we found that the use of the terms ‘prospective’ and ‘retrospective’ did not change after publication of the STROBE guideline, suggesting no impact of STROBE on the use of these terms. The lack of any association of the use of these terms to the overall adherence to the rest of STROBE’s advice further suggests this is not an intentional ignoring of STROBE’s advice in general. Rather, this seems specific to this particular part of STROBE’s advice, possibly because authors are not aware of this advice. We envision two possible actions. Either there should be an effort to make people aware of the advice to avoid the terms ‘prospective’ and retrospective’, or the STROBE should be updated and this advice should be removed. The decision which of these two options to follow should ultimately depend on the outcome of a discussion on the merits and perils of using these terms, among a broad representation of the medical scientific community.