The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index; none of the 2 sources its claims cite is checked for support yet.
Cross-Sectional Studies
Open accessAbstract
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.
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In the paper
“Prevalenceincidence bias (also called the Neyman bias) is also particularly common in cross-sectional studies.13”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Bias
What the sources say
- Not checked — no full text of the sourcecites [13] Tripepi, 2010, Selection bias and information bias in clinical research, Nephron Clin Pract source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“They cannot be used to look at individual change (as in a cohort study).”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Description of Subtypes of Cross-Sectional Studies
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > General Overview of Cross-Sectional Study Design
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Description of Subtypes of Cross-Sectional Studies · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, repeated cross-sectional studies can be used for analyzing population changes over time (also known as aggregate change over time).”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Description of Subtypes of Cross-Sectional Studies
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“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”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Sample Size Determination
What the sources say
- Not matchedcites [6] Fleiss, 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Unlike studies starting from a series of patients, cross-sectional studies often need to select a sample of subjects from a large and heterogeneous study population.Thus, they are susceptible to sampling bias.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Benefits and Downside of Cross-Sectional Studies
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The subjects are neither deliberately exposed nor treated; thus, there are seldom ethical difficulties.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Benefits and Downside of Cross-Sectional Studies
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
- Probably not a substantial claim. 4
- It may state two separate claims as one. 3
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Additional information
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Confounding could result in a distortion of the association between exposure and outcome.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Confounding
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Note that the sample size in a descriptive study does not depend on statistical power because this concept only applies to statistical comparisons.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Sample Size Determination
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Benefits and Downside of Cross-Sectional Studies
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
- Also stated in: § 1. The study population and the research question. · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Additional information
Strength:plain· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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.”
§ Cross-Sectional Studies Strengths, Weaknesses, and Recommendations > Bias
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
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.”
Citations
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“Furthermore, our data are susceptible to biases such as low insight, social desirability, or self-concept bias (Wang & Cheng, 2020 ).”
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Always on duty - Fostering climate resilience in the nursing profession: A discussion paper
Baumbusch, J., Yip, I. S., & Bandara, N. A. (2025) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2025.105227 · Cited by 2
Abadiga, Z. A., Koyas, K., & Tulu, A. H. (2025) · School Science and Mathematics · doi:10.1111/ssm.18400 · Cited by 2
Olariu, T. R., Lighezan, R., Ursoniu, S., et al. (2025) · Microorganisms · doi:10.3390/microorganisms13102313 · Cited by 1
Obuobisa‐Darko, T., Asiedu, E. A., Ohemeng, F. L. K., & Parku, K. E. (2025) · International Journal of Public Leadership · doi:10.1108/ijpl-12-2024-0147 · Cited by 1
Employability of patient-reported experience measures (PREMs) in dentistry: a scoping review
ATTAR, A. M., & Shukla, K. (2025) · BDJ · doi:10.1038/s41415-025-8812-2 · Cited by 1
“68,69 Population and gender distribution The majority of the studies combined adult and geriatric age groups during PREM assessment.”
Zou, R., Liu, F., Lin, Y., et al. (2025) · Clinical Oral Investigations · doi:10.1007/s00784-025-06555-3 · Cited by 1
“Second, in terms of research design, the cross-sectional study design makes it difficult to establish a causal temporal relationship between edentulism and sys - temic diseases [49].”
Tariq, M. B., Jaffar, N., Farhan, K., et al. (2025) · BMC Women s Health · doi:10.1186/s12905-025-04051-0 · Cited by 1
He, X., Liu, C., Cui, L., et al. (2025) · Supportive Care in Cancer · doi:10.1007/s00520-025-10013-x · Cited by 1
Ryan, S. E., Mansoor, A., Vani, M., & Sabiston, C. (2025) · Body image · doi:10.1016/j.bodyim.2025.101978 · Cited by 2
Gutkowska, K., Wierzbicka, E., Madej, D., Czarniecka‐Skubina, E., & Hamułka, J. (2025) · Nutrition Journal · doi:10.1186/s12937-025-01231-4 · Cited by 1
“They are widely used in research and have inherent advantages and disadvantages that should be carefully considered when designing studies and interpreting results [88].”
Factors Influencing Eating Habits of Video Gamers and Professional eSports Gamers in Peru
Caycho, J. M., Lozada-Urbano, M. F., Aguirre-Ipenza, R., & Contreras, P. J. (2025) · Foods · doi:10.3390/foods14213597 · Cited by 1
Redefining library user engagement through AI-enabled virtual assistants : a systematic review
Okeyo, S., & Rutere, J. (2025) · KLISC Journal of Information Science & Knowledge Management · doi:10.61735/yyzbgj77 · Cited by 1
Jacq, G., Sboui, G., Lascarrou, J.-B., Bailly, P., Beuret, P., Bruel, C., Holleville, M., Pichon, N., Chambon, R., Desmeulles, I., et al. (2025) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2025.110795 · Cited by 1
The Role of Health Literacy in Adults' Dental Service Utilisation: A Scoping Review
Lu, X., Nanjappa, S., Wijesiri, T. I. D., Mossey, P. A., & Yuan, S. (2025) · Community Dentistry And Oral Epidemiology · doi:10.1111/cdoe.70037 · Cited by 5
“Third, over half the studies relied on self-report questionnaires and mostly used cross-sectional design, which may generate reporting biases and not accurately reflect health literacy levels or dental service utilisation over time [54, 55].”
Petkovski, M., Steinrücke, J., & Rodríguez, A. D. (2026) · PLoS ONE · doi:10.1371/journal.pone.0349585 · Cited by 1
“While cross-sectional data does not allow to infer causality [48], we used (moderated) mediation models to explore preliminary relationships between the eco-emotions and PEB.”
Wirnitzer, K., Tanous, D., Drenowatz, C. J., Wirnitzer, G., Schätzer, M., Ruedl, G., & Kirschner, W. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1677900 · Cited by 2
“…from the results (146), the study design does allow for large samples to be accessed with particularly relevant themes based on previous literature to better elaborate the context of important areas for aiding future research with interventional designs or even randomized controlled trials (146).”
Zanuzo, K., Nishiyama, M. F., Koehnlein, E. A., & Grassiolli, S. (2025) · Pathophysiology · doi:10.3390/pathophysiology32040064 · Cited by 1
“This design demonstrates high internal validity, providing consistent results for the sample analyzed, but as indicated for Wang and Cheng [97] it limited external validity, thereby restricting the generalizability of the findings to other populations.”
Rejeb, A., Rejeb, K., & Süle, E. (2025) · Energy Nexus · doi:10.1016/j.nexus.2025.100595 · Cited by 1
Indriyani, R., Murti, B., Anggraini, N. A., & Puspitasari, Y. (2025) · Social Sciences & Humanities Open · doi:10.1016/j.ssaho.2025.102122 · Cited by 1
Prevalence and correlates of burnout among radiographers in Harare Metropolitan Province, Zimbabwe
Murungweni, P., Mudadi, L.-S., Odumeru, E., & Chinene, B. (2025) · Radiography · doi:10.1016/j.radi.2025.103247 · Cited by 1
Physical and neurobiological depression-associated factors: A cross-sectional study
de Bruin, E. D., Buffat, N., Brunner, E., Vancampfort, D., Büchi, S., Jenewein, J., & Eggenberger, P. (2025) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2025.100998 · Cited by 1
The relationship between fat-soluble vitamins and uterine fibroids: a systematic review
Dashti, S., Marvi, F. J., Jazayerinezhad, N., et al. (2025) · BMC Women s Health · doi:10.1186/s12905-025-04189-x · Cited by 1
Sutherland, O., Kafwimbi, S., Sichone, J., et al. (2025) · Radiography · doi:10.1016/j.radi.2025.103261 · Cited by 1
Jokwiro, Y., Wang, Q., Bassett, J., et al. (2025) · Nursing Reports · doi:10.3390/nursrep15120429 · Cited by 1
“Furthermore, the reliance on self-reporting data may potentially be subject to recall and selection bias [35], and the relative criteria used for reliability and dimensionality is far from being absolute [34].”
Baruah, A. G. (2025) · Regional Environmental Change · doi:10.1007/s10113-025-02488-5 · Cited by 1
“First, the cross-sectional nature of the study restricts the ability to establish causal links between independent variables and QoL outcomes a longer period of time (Wang and Cheng 2020).”
Ruzhani, F., & Mushunje, A. (2025) · Cogent Food & Agriculture · doi:10.1080/23311932.2025.2596361 · Cited by 1
“To gather this data, a cross-sectional survey design, which is a type of research design in which data is collected from different individuals at a single point in time (Wang & cheng, 2020), was used.”
Salahudeen, M. S., Baker, W., & Douglas, T. (2025) · American Journal of Pharmaceutical Education · doi:10.1016/j.ajpe.2025.101912 · Cited by 4
Nakamatte, I., Ilukor, J., & Kibwage, J. K. (2025) · Frontiers in Sustainable Food Systems · doi:10.3389/fsufs.2025.1667492 · Cited by 1
Mankelkl, G., Abdu, S. M., Assefa, E. M., Kassaw, A. B., Abebe, G., Belete, M., Tareke, A. A., Alem, A., Bihonegn, M. D., Abdu, H., et al. (2025) · BMC Infectious Diseases · doi:10.1186/s12879-025-12279-2 · Cited by 1
Matandika, I., Mnenula, M., & Lutala, P. M. (2025) · BMC Palliative Care · doi:10.1186/s12904-025-01940-x · Cited by 1
“Being cross-sectional, it is subject to recall bias and does not allow for conclusions about causality [35].”
Adaptation of the cognitive flexibility scale
Evanytha, Riyanti, B. P. D., & Herabadi, A. G. (2025) · Current Psychology · doi:10.1007/s12144-025-08867-9 · Cited by 1
“Research participants in cross-sectional studies come from populations that are available and relevant to the research problem and questions (X. Wang & Cheng, 2020).”
The Influence of Human Resource Competence in Marketing on Sales Performance of (SMEs) in Indonesia
Fadillah, M. (2025) · Journal of State Economic Research · doi:10.65101/jser.v1i1.49 · Cited by 1
“Pendekatan cross-sectional ini memungkinkan pengumpulan data dari populasi yang beragam pada satu titik waktu, yang cocok untuk analisis hubungan antara variabel-variabel penelitian [10].”
Wikki, I., Palmu, J., Kauko, A., Havulinna, A. S., Jousilahti, P., Lahti, L., Knight, R. D., Salomaa, V. V., & Niiranen, T. (2025) · Respiratory Research · doi:10.1186/s12931-025-03453-w · Cited by 1
“The primary strength is that this is the first report on the long-term prospective association between gut microbiota and incident pneumonia, thus avoiding many biases inherent in cross-sectional studies [58].”
Nzao, A. N., Katundu, M. A., & Muhihi, B. G. (2025) · African Quarterly Social Science Review · doi:10.51867/aqssr.2.4.70 · Cited by 1
“A cross-sectional research design was employed to capture AES accessibility and its determinants at a single point in time (Wang & Cheng, 2020).”
Annunziata, G., Lambiase, S., Palomba, F., et al. (2025) · International Conference on Evaluation and Assessment in Software Engineering (EASE) · doi:10.1145/3756681.3756941 · Cited by 1
Kachota, B., Bernard, R., & Hokororo, S. J. (2025) · Journal of Library Administration · doi:10.1080/01930826.2025.2597156 · Cited by 1
“This study adopted a cross-sectional research design to collect data from a population at a single point in time, making it an efficient and cost-effective approach (Wang & Cheng, 2020).”
Bam, V. B., Diji, A. K., Lartey, S. D., Nabirye, R. C., Owusu‐Ansah, F. E., Lomotey, A. Y., Larsen-Reindolf, R. E., & Budu, H. I. (2026) · BMC Medical Education · doi:10.1186/s12909-025-08554-0 · Cited by 1
Essouma, M., Nkeck, J. R., Agbor, V. N., Tchaptchet, P., Dalle, U. D., Yondo, J. C. N., Tchouda, L. A. S., Momo, Y. C. B., Akoa, D. A., & Nkeck, J. P. (2026) · Phlebology The Journal of Venous Disease · doi:10.1177/02683555251413935 · Cited by 1
Institutional pressure and pollution control: small and medium-sized enterprises
Wang, L., Zhang, M., & Li, L. (2026) · Management Decision · doi:10.1108/md-02-2025-0278 · Cited by 1
Studies on cropping systems and pesticide regimes in Tolon, in the Northern Region of Ghana
Dohbia, A.-R. A., Adu‐Acheampong, S., Blankson, E. R., et al. (2026) · Journal of Applied Life Sciences and Environment · doi:10.46909/alse-584193 · Cited by 1
Claes, R., Denies, K., Smedt, B. D., & Aesaert, K. (2026) · Large-scale Assessments in Education · doi:10.1186/s40536-025-00277-4 · Cited by 2
“This approach constrains our capacity to establish causality or delineate the directionality of these relationships (Wang & Cheng, 2020).”
Metadata
- 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
- FWCI
- 90.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- CHEST Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Health Sciences › Nursing › Research and Theory › 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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