Evidence map›Paper›PMID 27932337›Full record

ArticleBMJ open2016

Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS).

Martin J Downes, Marnie L Brennan, Hywel C Williams, Rachel S Dean

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1,111 papers, 117 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1,111citing papers in PubMed, 117 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1,111 citing papers in PubMed, 117 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Smoking and disability outcomes in multiple sclerosis: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Pooled it
  16. Pooled it
  17. Pooled it
  18. Pooled it
  19. Cutaneous T-cell lymphomas and dupilumab for atopic dermatitis: A systematic review and expert consensus.Journal of the European Academy of Dermatology and Venereology : JEADV · 2026
    Pooled it
  20. Pooled it

1,051 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Martin J DownesCentre for Applied Health Economics, School of Medicine, Griffith University, Meadowbrook, Queensland, Australia.
Marnie L BrennanCentre for Evidence-based Veterinary Medicine, The University of Nottingham, Loughborough, UK.
Hywel C WilliamsCentre of Evidence Based Dermatology, The University of Nottingham, Nottingham, UK.
Rachel S DeanCentre for Evidence-based Veterinary Medicine, The University of Nottingham, Loughborough, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe aim of this study was to develop a critical appraisal (CA) tool that addressed study design and reporting quality as well as the risk of bias in cross-sectional studies (CSSs). In addition, the aim was to produce a help document to guide the non-expert user through the tool.

designAn initial scoping review of the published literature and key epidemiological texts was undertaken prior to the formation of a Delphi panel to establish key components for a CA tool for CSSs. A consensus of 80% was required from the Delphi panel for any component to be included in the final tool.

resultsAn initial list of 39 components was identified through examination of existing resources. An international Delphi panel of 18 medical and veterinary experts was established. After 3 rounds of the Delphi process, the Appraisal tool for Cross-Sectional Studies (AXIS tool) was developed by consensus and consisted of 20 components. A detailed explanatory document was also developed with the tool, giving expanded explanation of each question and providing simple interpretations and examples of the epidemiological concepts being examined in each question to aid non-expert users.

conclusionsCA of the literature is a vital step in evidence synthesis and therefore evidence-based decision-making in a number of different disciplines. The AXIS tool is therefore unique and was developed in a way that it can be used across disciplines to aid the inclusion of CSSs in systematic reviews, guidelines and clinical decision-making.

Indexed as

BiasClinical Decision-MakingConsensusCross-Sectional StudiesDelphi TechniqueEvidence-Based MedicineHumansResearch DesignCritical appraisalCross sectional studiesDelphiEvidence-based Healthcare

Identifiers

PMID27932337
PMCPMC5168618

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.