Research Article: STrengthening the REporting of Genetic Association Studies (STREGA)— An Extension of the STROBE Statement

Date Published: February 3, 2009

Publisher: Public Library of Science

Author(s): Julian Little, Julian P.T Higgins, John P.A Ioannidis, David Moher, France Gagnon, Erik von Elm, Muin J Khoury, Barbara Cohen, George Davey-Smith, Jeremy Grimshaw, Paul Scheet, Marta Gwinn, Robin E Williamson, Guang Yong Zou, Kim Hutchings, Candice Y Johnson, Valerie Tait, Miriam Wiens, Jean Golding, Cornelia van Duijn, John McLaughlin, Andrew Paterson, George Wells, Isabel Fortier, Matthew Freedman, Maja Zecevic, Richard King, Claire Infante-Rivard, Alex Stewart, Nick Birkett

Abstract: Julian Little and colleagues present the STREGA recommendations, which are aimed at improving the reporting of genetic association studies.

Partial Text: The rapidly evolving evidence on genetic associations is crucial to integrating human genomics into the practice of medicine and public health [1,2]. Genetic factors are likely to affect the occurrence of numerous common diseases, and therefore identifying and characterizing the associated risk (or protection) will be important in improving the understanding of etiology and potentially for developing interventions based on genetic information. The number of publications on the associations between genes and diseases has increased tremendously; with more than 34 000 published articles, the annual number has more than doubled between 2001 and 2008 [3,4]. Articles on genetic associations have been published in about 1500 journals and in several languages.

A multidisciplinary group developed the STREGA Statement by using literature review, workshop presentations and discussion, and iterative electronic correspondence after the workshop. Thirty-three of 74 invitees participated in the STREGA workshop in Ottawa, Ontario, Canada, in June, 2006. Participants included epidemiologists, geneticists, statisticians, journal editors and graduate students.

In Table 1, we present the STREGA recommendations, an extension to the STROBE checklist [55] for genetic association studies (an editable version of Table 1 is provided as Table S1 under Supporting Information). The resulting STREGA checklist provides additions to 12 of the 22 items on the STROBE checklist. During the workshop and subsequent consultations, we identified five main areas of special interest that are specific to, or especially relevant in, genetic association studies: genotyping errors, population stratification, modelling haplotype variation, HWE and replication. We elaborate on each of these areas, starting each section with the corresponding STREGA recommendation, followed by a brief outline of the issue and an explanation for the recommendations. Complementary information on these areas and the rationale for additional STREGA recommendations relating to selection of participants, choice of genes and variants selected, treatment effects in studying quantitative traits, statistical methods, relatedness, reporting of descriptive and outcome data, and issues of data volume, are presented in Table 2.

The choices made for study design, conduct and data analysis potentially influence the magnitude and direction of results of genetic association studies. However, the empirical evidence on these effects is insufficient. Transparency of reporting is thus essential for developing a better evidence base (Table 2). Transparent reporting helps address gaps in empirical evidence [45], such as the effects of incomplete participation and genotyping errors. It will also help assess the impact of currently controversial issues such as population stratification, methods of inferring haplotypes, departure from HWE and multiple testing on effect estimates under different study conditions.



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