Cross-sectional Study designs
Dr Hamid Hussain
LEARNING OBJECTIVES
Learner should be able to know at the end of this lecture
Classify study designs? Descriptive and Analytical epidemiology? What is a cross-sectional study? When to conduct cross-sectional study? How to test the hypothesis by means of a crosssectional study?
PERFORMANCE OBJECTIVES
LEARNER SHOULD BE ABLE TO
Conduct the cross-sectional study for
any new hypothesis
Apply this cross sectional analytical method when situation demands
Study design: Definition
A study design is a specific plan or protocol for conducting the study, which allows the investigator to translate the conceptual hypothesis into an operational one.
Study designs
Study types
Descriptive (formulation hypothesis)
Analytical (testing hypothesis)
Individual based
Population based
Observational
Interventional
Case studies
co-relational
Case-control
RCTs (III)
Quazi experimental
Case series cohort
Crosssectional
Descriptive Studies
Descriptive studies describe the pattern of disease in relation to Person, Place and Time. Descriptive studies use information from diverse sources like clinical records of hospital or private practices as well as national figures. While features inherent in their design preclude the ability to test hypotheses, these studies are very useful to describe the pattern of disease occurrence as well as formulate research questions.
Descriptive Studies
Descriptive studies are the most frequently encountered study design
The identification of descriptive characteristics frequently constitutes an important first step in the search for determinants or risk factors that can be altered or eliminated to reduce or prevent the disease.
Descriptive study designs
Case Report
Case Series
One case of unusual finding Multiple cases of finding Population-based cases with denominator
Descriptive Epidemiology Study
Descriptive Studies
Increasing Knowledge of Disease/Exposure
Develop hypothesis
Cross sectional studies Investigate its relationship to outcomes Define its meaning with exposures
Case-control Studies
Cohort Studies
Clinical trials
Test link experimentally
Study Designs Analytic Epidemiology
Experimental Studies
Randomized controlled clinical trials Quazi experimental studies
Observational Studies
Group data Ecologic Individual data Cross-sectional Cohort Case-control Case-crossover
Cross-sectional study
A cross-section is the shape that results from
cutting a slice from an object.
The sampling frame usually conforms to the
snapshot analogy.
A cross-sectional study studies, disease and risk factor patterns in a representative part of the population, in a narrowly defined time period.
Cross Sectional
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Cross sectional study
Primarily, this study provides information
on prevalence of disease and risk factors.
The measurements are made over a
relatively short period of time such as a year
or two.
Excellent for measuring the population
burden of disease.
Cross-sectional study
It also can seek associations, generate and
test hypotheses and, by repetition, be used to measure change. Ideal cross-sectional study is of a geographically defined, representative sample of the population studied within a slice of time and space.
Cross sectional study
People representing virtually all stages
of health and disease.
Indirect insights on the natural history.
Cross-sectional studies
An observational design that surveys exposures and disease status at a single point in time (a cross-section of the population)
time Study only exists at this point in time
Cross-sectional Design
factor present No Disease
factor absent
Study population factor present
Disease
factor absent
time Study only exists at this point in time
Design
Define population
Gather Data on Exposure and Disease
Exposed and have the disease (a)
Exposed but have no disease (b)
Not Exposed and have the disease (c)
Neither Exposed nor have the disease (d)
Analysis: Cross Sectional design
Disease No disease
Exposed Not exposed Total
a
c
a+c
b
d
b+d a+b+c+d
Odds Ratio
Disease DVT 40 10 No DVT 20 30
Exposure
Used OC No OC
Number developing DVT among OC users/ Number developing DVT among Non users NOT developing DVT among OC users/ NOT developing DVT among Non users
Odds Ratio = 40/10 20/30 = 4/0.67 = 5.97 or 6 The odds of DVT in OC users was 6 times the odds of DVT in NON OC users
Cross-sectional Studies are Often used
to study conditions that are relatively frequent with long duration of expression (nonfatal, chronic conditions)
It measures prevalence
It can not measure incidence of disease
Not suitable for studying rare or highly fatal diseases or a disease with short duration
Cross-sectional Studies
Advantages;
Easy to carry out. Economical to conduct Rapid method for collecting health information as part of Rapid Epidemiological Assessment (R.E.A) methodology. Can be conducted to assess the health care needs of the population.
Advantages;(contd)
Helpful in measuring access and utilization of health services. Helpful in developing an etiological hypothesis. Provides information between disease and various variables. Provides information regarding distribution of a disease. Determines burden of the diseases in a population. So helpful for planning purposes.
Cross-sectional studies
Disadvantages Weakest observational design, (it measures prevalence, not incidence of disease). Gives no measure
of new cases occurrence
The temporal sequence of exposure and effect may be difficult or impossible to determine So gives no
information whether which comes first e.i. Cause or Disease.
Rare events are a problem. Prevalent cases are survivors. Gives no direct idea about
natural history of the disease or etiology. Neymans bias. Miss earlier cases that have died or recovered
