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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Claims the paper makes
11 Own interpretation · 1 Sources not found · 1 No full text of the sources
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
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a 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
“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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a 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 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In 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.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a 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
“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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably 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
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It 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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“Cross-sectional studies are suitable for estimating the prevalence of health-related phenomena and exploring associations at a speci fi c point in time, particularly when time and resource constraints preclude longitudinal approaches (Wang & Cheng, 2020).”
Exploring the literacy-behaviour among agricultural science university students
Asante, I. K., Amfo‐Antiri, A., Omega, S., Ansah, R., Mensah, J. V., Akoto, P., Williams, A., & Uthman, F. (2026) · Discover Food · doi:10.1007/s44187-026-01017-5
Wang, C., Li, L.-J.-Y., Zhu, X.-X., Yu, H., & Yu, L.-M. (2025) · Integrate Medicine · doi:10.61958/imzw2201
Santi, T., Setiabudiawan, T. P., Aviani, J. K., Alfaqih, M. S., Jaqualina, C., Nanova, A. F. R., Saila, K. A. P., & Setiabudiawan, B. (2026) · medRxiv · doi:10.64898/2026.05.05.26351787
Deriving personalized HRM practices using employee-AI collaboration: A shared mental model approach
Awan, S. N., & Muhammad, G. (2026) · Acta Psychologica · doi:10.1016/j.actpsy.2026.107029
Hategekimana, S., & Ali, S. R. (2026) · Egyptian Nursing Journal · doi:10.4103/enj.enj_5_26
Post-ischemic stroke epilepsy in adults: A cross-sectional study
Zafra, M. P., Ferreira‐Atuesta, C., Moreno-Vargas, E. A., et al. (2026) · Neurology Perspectives · doi:10.1016/j.neurop.2026.100226
Nurmansyah, M. I., Caze, A. L., Edmunds, K., et al. (2026) · Critical Public Health · doi:10.1080/09581596.2026.2670045
Valderrama-Molina, C. O., & Rueda, M. F. G. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-34264-6.00007-1
Ismiyati, Suminah, Sukamto, I. S., et al. (2026) · Social Sciences & Humanities Open · doi:10.1016/j.ssaho.2026.102887
The association between paternal PTSD and child mental health: a systematic literature review
Etheridge, L. L., Moon, S., Scheffert, A., Chan-Park, C. Y., & Clark, D. (2026) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-026-01073-w
“Reference articles were used to increase proficiency in conducting article reviews to identify essential characteristics, strengths, weakness, methodological issues, design issues, and statistical results [42, 61].”
Health literacy research in primary healthcare services – A scoping review
Borge, C. R., Eik, H., Wahl, A. K., Bragstad, L. K., Sylwander, C., Urstad, K. H., Leine, M., Opheim, R., Mengshoel, A. M., Holmen, H., et al. (2026) · Patient Education and Counseling · doi:10.1016/j.pec.2026.109675
The complexities of athlete development in North American professional sport
Lablans, D., Johnston, K., & Baker, J. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1804236
Mamić, M., Mamić, I., Farčić, N., Lovrić, R., Barać, I., Mudri, Ž., Barišić, M., Dujmić, Ž., Puharić, Z., & Vukoja, I. (2026) · Nursing Reports · doi:10.3390/nursrep16050169
“The study was conducted as a cross-sectional observational study and is presented in accordance with the STROBE guidelines for cross-sectional studies [26].”
Mbhenyane, X. G., Ruiters, R., & Zuma, M. K. (2026) · Sustainability · doi:10.3390/su18105126
Diagnostic Prediction Models for Depression in Patients With Breast Cancer: A Systematic Review
Yu, X., Zhang, L., Wan, Q., Chen, S., & Wang, X. (2026) · Journal of Clinical Nursing · doi:10.1111/jocn.70365
Self-citationShah, A., Salma, U., Aman, N., Ali, M., Ali, R., Dahesh, S., Qamar, S., Moeen, Mustafa, N., Shah, M., et al. (2026) · The Open Public Health Journal · doi:10.2174/0118749445450238260511201959
Zai, I., & Zai, A. (2026) · JMIR Dermatology · doi:10.2196/90820
“While these approaches provide important insights into symptom burden and quality of life, they are limited in their ability to establish temporal relationships or estimate population-level risk [20,21].”
Organizational silence and work alienation: a study on public hospital health employees
Envergil, D., & Özdal, M. A. (2026) · BMC Health Services Research · doi:10.1186/s12913-026-14745-2 · Cited by 1
“Similarly, previous studies have shown that health employees’ total work alienation scores differ significantly depending on their position [26, 28, 29].”
Birth Mode Preferences and Associated Factors Among Jordanian Pregnant Women
AbuAlrub, S., Hamdan, F. R., Baker, M. A., Al-Momani, E., Etoom, M., & Hilwah, L. (2026) · SAGE Open Nursing · doi:10.1177/23779608261453437
“Furthermore, it is typically cost-effective and straightforward to execute (Wang & Cheng, 2020).”
Bonn, K., Wohlfarth, D., Timm, I., Bender, O., Ebner‐Priemer, U., & Giurgiu, M. (2026) · JMIR mhealth and uhealth · doi:10.2196/81502
“…is derived from cross-sectional designs [41,45,47] that analyze between-person differences at a single time point and are therefore inherently limited in their ability to elucidate temporal within-person dynamics, including day-to-day variability in 24-hour physical behavior and stress [48,49].”
Analysis of factors influencing Rice yield and prices in Iringa irrigation schemes
George, V. (2026) · Western Balkan Journal of Agricultural Economics and Rural Development · doi:10.5937/wbjae2501067g
Stephen, D., Devika, S., Sudheer, D., Jaison, D. A., John, E., Sunny, F., Kuriakose, F., Gopinath, G., Joy, G., Rahman, H., et al. (2026) · International Journal of Nursing Education and Research · doi:10.52711/2454-2660.2026.00029
Kubica, C., Zimmermann, S., & Nigg, C. R. (2026) · BMC Women s Health · doi:10.1186/s12905-026-04503-1
“Furthermore, as with all self-reported measures, recall bias and social desirability bias cannot be excluded [77].”
Financial hardship and pain among cancer survivors: a French nationwide cross-sectional analysis
Girardon, L., Ragusa, C., Laporte, F., Pereira, B., & Balayssac, D. (2026) · Supportive Care in Cancer · doi:10.1007/s00520-026-10829-1
“As a cross-sectional, self-reported study, this work is subject to the inherent limitations of observational research [56].”
Wojtaszczyk, K., Mizera‐Pęczek, P., Różańska‐Bińczyk, I., Syper‐Jędrzejak, M., & Łuczak, P. (2026) · Young Consumers Insight and Ideas for Responsible Marketers · doi:10.1108/yc-03-2025-2476
Milala, H. C., & Kaombe, T. M. (2026) · Reproductive Health · doi:10.1186/s12978-026-02372-3
“Therefore, these results should be interpreted as associative rather than causal [53].”
Brattland, T. L. L., Larsen, M. D., & Bojanić, I. (2026) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-026-03115-2
Liu, C.-H. S., Lu, I.-Y., Gan, B. K., et al. (2026) · Asia Pacific Journal of Marketing and Logistics · doi:10.1108/apjml-10-2025-2187
Taha, A. T., Zhang, Y. S., Ma, C. J., et al. (2026) · Journal of Personalized Medicine · doi:10.3390/jpm16060286
“The purpose of a repeated cross-sectional design was to observe trends in retinal microvasculature at various time points from different subjects sampled from the same population [32].”
Leal, J. A., Souza, M. S. S., Viola, T. W., & Grassi‐Oliveira, R. (2026) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2026.101091
How to … Choose a Methodology for Health Professions Education Research
Politis, M., Stelling, H., Brown, M., & Alberti, H. (2026) · The Clinical Teacher · doi:10.1111/tct.70450
Valles-Coral, M. A., Injante, R., Pinedo, L., et al. (2026) · Data · doi:10.3390/data11060129
“The study adopted an observational cross-sectional design with an analytical approach [18], aimed at modeling academic stress as a multidimensional phenomenon in university students.”
Nurses’ Knowledge of Blood Transfusion Safety at Intensive Care Units in Jordan
Jasser, N. F. A., Alrida, N. A., Hayajneh, F. A., et al. (2026) · Critical Care Nursing Quarterly · doi:10.1097/cnq.0000000000000617
Understanding and applying research methodologies in primary care
James, C., Nair, P., Greenfield, G., & Hayhoe, B. W. J. (2026) · InnovAiT Education and inspiration for general practice · doi:10.1177/17557380261450096
“Cross-sectional studies cannot readily assess incidence, study rare disease or causality and are often prone to sampling, non-response, Neyman (Hill, 2003) and recall bias (Wang and Cheng, 2020).”
Longo, L., & Kelly, A. M. (2026) · Journal of Science Teacher Education · doi:10.1080/1046560x.2026.2681220
Only Time Will Tell: A Structured Survey of Longitudinal Studies on Social AI Companions
Pi, Y., & Hunter, R. (2026) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2026.2670529
Exploring how executive function and motivation shape deep and surface learning
Pretorius, L., & Heyns, M. M. (2026) · Quarterly review of distance education · doi:10.1108/qrde-02-2026-0006
A Scoping Review of School-Based Mental Health Measurement in Adolescents
Andayani, T. R., & Hidayati, F. (2026) · Indigenous Jurnal Ilmiah Psikologi · doi:10.23917/indigenous.v11i1.13667
“Although effective for evaluating adolescent mental health at a single point in time, this design is less ideal for observing long-term changes (X. Wang & Cheng, 2020).”
Kadın Mutfak Personelinin Mesleki Stres Faktörlerinin İş-Yaşam Dengesine Etkisi
Özdamar, M. (2026) · Akdeniz Kadın Çalışmaları ve Toplumsal Cinsiyet Dergisi · doi:10.33708/ktc.1736576
Linkages Between Climate Change Anxiety, Mental Health, and Eco-Activism in University Students
Bettmann, J. E., Mitra, S. J., Speelman, E. A., & Conley, K. (2026) · Journal of College Student Mental Health · doi:10.1080/28367138.2026.2678825
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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