Evidence map›Paper›PMID 40293188›Full record

ArticleJournal of periodontal research2026

Risk of Bias Evaluation of Cross-Sectional Studies: Adaptation of the Newcastle-Ottawa Scale.

Maria Clotilde Carra, Pierluigi Romandini, Mario Romandini

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of periodontal research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 132 papers, 63 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
132citing papers in PubMed, 63 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

132 citing papers in PubMed, 63 syntheses or guidelines pooled it.

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72 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

3 authors.

Maria Clotilde CarraDepartment of Translational Medicine, University of Ferrara, Ferrara, Italy.ORCID https://orcid.org/0000-0002-5717-3274
Pierluigi RomandiniDivision of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.
Mario RomandiniPerio-Implant Innovation Center, Institute for Integrated Oral, Craniofacial and Sensory Research-National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0001-5646-083X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cross-sectional studies are widely utilized in medical research to estimate prevalence and examine associations. As such, they can serve as a significant source of data for systematic reviews. However, specific considerations are necessary when evaluating the risk of bias (RoB) of cross-sectional studies, as several potential biases can undermine the validity, reliability, and robustness of their findings. This article introduces a novel, context-specific tool designed to assess the RoB of cross-sectional studies for use in systematic reviews. The proposed tool represents an adaptation of the Newcastle-Ottawa Scale (NOS), originally developed for cohort and case-control studies. Similar to the original NOS, the new tool (named "NOS-xs") features a nine-star rating system to assess six specific items across three main domains: (i) study sample selection, (ii) assessment of exposure(s) and outcome(s), and (iii) confounding factors. Based on the number of awarded stars, studies are categorized as having high (0-3 stars), moderate (4-6 stars), or low (7-9 stars) RoB. The NOS-xs tool maintains consistency with the original NOS tool, facilitating its integration into systematic reviews that also include cohort and/or case-control studies. While the NOS-xs is suited to analytical cross-sectional studies (i.e., association studies), a simplified version ("NOS-xs2") is also introduced for descriptive cross-sectional studies (i.e., prevalence studies). The NOS-xs2 features a four-star rating system to assess three of the six specific items included in the NOS-xs. To streamline their application, spreadsheets for both NOS-xs and NOS-x2 are provided.

Indexed as

BiasCross-Sectional StudiesConfounding Factors, EpidemiologicHumansReproducibility of ResultsResearch Designbiascross‐sectional studiesepidemiologic factorsepidemiologymethodsprevalencerisk factorssystematic review

Identifiers

PMID40293188
PMCPMC13665615

What OpenQuestion holds

Textmetadata
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.