Cited by 2,214Statistical Methods in EpidemiologyMethodologies in Health Research and PracticeMeta-analysis and systematic reviews

Cross-Sectional Studies

Open access
Wang, Xiaofeng, Cheng, Zhenshun·2020·CHEST

Abstract

Cross-sectional studies are observational studies that analyze data from a population at a single point in time. They are often used to measure the prevalence of health outcomes, understand determinants of health, and describe features of a population. Unlike other types of observational studies, cross-sectional studies do not follow individuals up over time. They are usually inexpensive and easy to conduct. They are useful for establishing preliminary evidence in planning a future advanced study. This article reviews the essential characteristics, describes strengths and weaknesses, discusses methodological issues, and gives our recommendations on design and statistical analysis for cross-sectional studies in pulmonary and critical care medicine. A list of considerations for reviewers is also provided.

Integrity signals

Registry

Crossref · 10.1016/j.chest.2020.03.012

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 2 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    Prevalence-incidence bias (Neyman bias) is particularly common in cross-sectional studies.

    “Prevalenceincidence bias (also called the Neyman bias) is also particularly common in cross-sectional studies.13”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Tripepi, 2010, Selection bias and information bias in clinical research, Nephron Clin Pract source
  • Interpretationreasoning

    Repeated cross-sectional studies cannot be used to look at individual change.

    “They cannot be used to look at individual change (as in a cohort study).”
    Quote in the paperNot a substantial claim
  • Interpretationreasoning

    Because outcome and exposure variables are measured at the same time in a cross-sectional study, it is relatively difficult to establish causal relationships from such a study.

    “Because the outcome and exposure variables are measured at the same time, it is relatively difficult to establish causal relationships from a cross-sectional study.”
    • Also stated in: § Description of Subtypes of Cross-Sectional Studies · plain
      “The exposures and outcomes are measured simultaneously; therefore, it is difficult to determine whether the exposures preceded or followed the outcomes in an analytical cross-sectional study.”
    • Also stated in: § Benefits and Downside of Cross-Sectional Studies · plain
      “The weaknesses of cross-sectional studies include the inability to assess incidence, to study rare diseases, and to make a causal inference.”
    Quote in the paperSubstantial claim
  • Interpretationreasoning

    Repeated cross-sectional studies can be used for analyzing population changes over time (aggregate change over time).

    “Thus, repeated cross-sectional studies can be used for analyzing population changes over time (also known as aggregate change over time).”
    Quote in the paperNot a substantial claim
  • Premisecitation

    If one wants to compare two prevalence rates in an analytical cross-sectional study, the commonly used sample size formula is the same as is used when designing a cohort study.

    “If one wants to compare two prevalence rates in an analytical cross-sectional study, the commonly used sample size formula is the same as is used when designing a cohort study.6”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [6] Fleiss, 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim. 4
  • May combine two claims. 3
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Stepwise selection methods and P value-based criteria often allow too many parameters to be included, which reduces the generalizability of the model.

    “Stepwise selection methods and P value-based criteria are discouraged due to overfitting and because they often allow too many parameters to be included, which reduces the generalizability of the model.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    Confounding could result in a distortion of the association between exposure and outcome.

    “Confounding could result in a distortion of the association between exposure and outcome.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    In a descriptive cross-sectional study, the sample size does not depend on statistical power because statistical power only applies to statistical comparisons.

    “Note that the sample size in a descriptive study does not depend on statistical power because this concept only applies to statistical comparisons.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim.

    Interpretationnone given

    Cross-sectional studies cannot assess incidence.

    “The weaknesses of cross-sectional studies include the inability to assess incidence, to study rare diseases, and to make a causal inference.”
    • Also stated in: § 1. The study population and the research question. · plain
      “Unable to measure the incidence”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given

    Only with full and transparent reporting of information on all aspects of a cross-sectional study can the potential usefulness of its findings and risk of bias be adequately assessed.

    “Only with full and transparent reporting of information on all aspects of a cross-sectional study can potential usefulness of its findings and risk of bias be adequately assessed.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    Because exposure and outcome are measured simultaneously in a cross-sectional study, prior knowledge of the condition might influence the ascertainment of the exposure or the outcome, resulting in recall bias.

    “Because exposure and outcome are measured simultaneously in a cross-sectional study, prior knowledge of the condition might influence the ascertainment of the exposure or the outcome, which results in recall bias.”
    Quote in the paperNot a substantial claim
6 of 6
  • The paper relies on this without support.

    Cross-sectional studies are usually quick and inexpensive to conduct.

    “They are usually inexpensive and easy to conduct.”
    “The main strength of cross-sectional studies is that they are relatively quick and inexpensive to conduct.”
  • The paper relies on this without support.

    Cross-sectional studies are the best way to determine prevalence.

    “They are the best way to determine the prevalence and can study the associations of multiple exposures and outcomes.”
  • The paper relies on this without support.

    Cross-sectional studies can study the associations of multiple exposures and outcomes.

    “They are the best way to determine the prevalence and can study the associations of multiple exposures and outcomes.”
  • The paper relies on this without support.

    Cross-sectional studies are useful for establishing preliminary evidence in planning a future advanced study.

    “They are useful for establishing preliminary evidence in planning a future advanced study.”
  • The paper relies on this without support.

    Cross-sectional studies are suitable for generating hypotheses and may provide information about the prevalence of outcomes and exposures that informs other study designs.

    “They are suitable for generating hypotheses and may provide information about the prevalence of outcomes and exposures that informs other study designs.”
  • The paper relies on this without support.

    Using questionnaires to reach a large sample of the population of interest is relatively inexpensive but can result in low response rates.

    “Using questionnaires to reach a large sample of the population of interest is relatively inexpensive but can result in low response rates.”
  • The paper relies on this without support.

    Interviews are more expensive and time-consuming than using questionnaires, potentially limiting the sample size but leading to a higher response rate.

    “Interviews are more expensive and time-consuming than using questionnaires, potentially limiting the sample size but leading to a higher response rate.”
  • The paper relies on this without support.

    Cross-sectional studies cannot study rare diseases.

    “The weaknesses of cross-sectional studies include the inability to assess incidence, to study rare diseases, and to make a causal inference.”
  • The paper relies on this without support.

    Probability sampling methods are more accurate and rigorous than nonprobability sampling methods.

    “In general, probability sampling methods are preferred over nonprobability ones, as the former are considered to be more accurate and rigorous.”
  • The paper relies on this without support.

    Nonresponse bias is usually encountered in cross-sectional survey studies with mailed questionnaires.

    “A common type of selection bias is the nonresponse bias, which is usually encountered in crosssectional survey studies with mailed questionnaires.”
  • The paper relies on this without support.

    Recall bias and detection bias are two common information biases.

    “Recall bias and detection bias are two common information biases.”
11 of 11

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Authors
Wang, X., & Cheng, Z.
Affiliations
  • Cleveland Clinic (US)
  • Zhongnan Hospital of Wuhan University (CN)
Corresponding author
Wang, Xiaofeng
Venue
CHEST
Publisher
Elsevier BV
Published
2020-07
Volume
158
Issue
1
Pages
S65-S71
ISSN
0012-3692 (ISSN-L)
OpenAlex
W3039445169
Cited by
2,214
References
29
Citations by year
2026: 636 · 2025: 638 · 2024: 423 · 2023: 282 · 2022: 162 · 2021: 61 · 2020: 8 · 2019: 3 · 2018: 1
FWCI
90.42
Type
journal article
Language
en
Open access
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
  • Health Sciences › Health Professions › Health Information Management › Methodologies in Health Research and Practice
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
Keywords
cross-sectional study, observational study design, prevalence, health determinants, methodological issues, statistical analysis, respiratory medicine, intensive care, research design recommendations, peer review
MeSH terms
Cross-Sectional Studies, Humans, Guidelines as Topic

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