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Questions and Answers
What is bias defined as in the context of research?
What is bias defined as in the context of research?
What type of bias occurs when there are systematic differences in baseline characteristics between groups?
What type of bias occurs when there are systematic differences in baseline characteristics between groups?
How can selection bias be avoided in RCTs?
How can selection bias be avoided in RCTs?
What is an example of selection bias?
What is an example of selection bias?
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What is performance bias?
What is performance bias?
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What is an example of performance bias?
What is an example of performance bias?
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Why is allocation concealment important in RCTs?
Why is allocation concealment important in RCTs?
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What is the purpose of effective randomization in RCTs?
What is the purpose of effective randomization in RCTs?
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What is the purpose of blinding in a trial?
What is the purpose of blinding in a trial?
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What is allocation concealment?
What is allocation concealment?
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What is attrition bias?
What is attrition bias?
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When is blinding not possible?
When is blinding not possible?
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What is the purpose of randomization in a trial?
What is the purpose of randomization in a trial?
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What is the difference between single-blind and double-blind trials?
What is the difference between single-blind and double-blind trials?
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What is the purpose of concealment in a trial?
What is the purpose of concealment in a trial?
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Why is allocation concealment universally recommended?
Why is allocation concealment universally recommended?
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What is conflict of interest bias?
What is conflict of interest bias?
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What is an example of a non-financial conflict of interest?
What is an example of a non-financial conflict of interest?
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What does the traffic light graph represent in a systematic literature review?
What does the traffic light graph represent in a systematic literature review?
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What does a red color in the traffic light graph indicate?
What does a red color in the traffic light graph indicate?
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What is the purpose of assessing the risk of bias in a systematic review?
What is the purpose of assessing the risk of bias in a systematic review?
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What is an example of a financial conflict of interest?
What is an example of a financial conflict of interest?
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What is the main purpose of assessing bias in a systematic review?
What is the main purpose of assessing bias in a systematic review?
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What does a yellow color in the traffic light graph indicate?
What does a yellow color in the traffic light graph indicate?
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What is a potential reason to exclude participants from a study after it has begun?
What is a potential reason to exclude participants from a study after it has begun?
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What is the purpose of recruiting more participants than needed for a sample?
What is the purpose of recruiting more participants than needed for a sample?
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What is detection bias also known as?
What is detection bias also known as?
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Why is it important to blind outcome assessors?
Why is it important to blind outcome assessors?
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What is reporting bias related to?
What is reporting bias related to?
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When does reporting bias occur?
When does reporting bias occur?
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What is the primary goal of minimizing follow-ups in a study?
What is the primary goal of minimizing follow-ups in a study?
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Why is it important to maintain detailed contact information for participants?
Why is it important to maintain detailed contact information for participants?
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Study Notes
Definition of Bias
- Bias is a systematic error or deviation from the truth in results.
- Biases can lead to underestimation or overestimation of the true intervention effect and can vary in magnitude.
Sources of Bias in RCT
Selection Bias
- Occurs when there are systematic differences in baseline characteristics between groups.
- Example: Selection of participants with differential age characteristics.
- How to avoid: Use randomization to minimize confounding variables and ensure comparable groups. Allocation concealment can also help prevent selection bias.
Performance Bias
- Occurs when there is unequal care between study groups.
- Example: An investigator who believes that self-ligating brackets collect less plaque and lead to lower plaque and periodontal index scores might follow patients with self-ligating brackets closer and offer more exhaustive oral-hygiene instructions.
- How to avoid: Blinding (single or double) can help prevent performance bias.
Attrition Bias
- Occurs when there is loss of participants from a sample after randomization (dropout).
- Attrition can lead to bias if the characteristics of participants with missing data are different between the randomized groups.
- How to avoid:
- Recruit more participants than needed for the sample (oversample).
- Provide compensation for attending every session.
- Minimize the number of follow-ups as much as possible.
- Make all follow-ups brief, flexible, and convenient for participants.
- Send routine reminders to schedule follow-ups.
Detection Bias
- Occurs when the outcome event is identified with different methods or criteria in the exposed and non-exposed groups.
- Also known as observer, ascertainment, or assessment bias.
- How to avoid: Blinding (or masking) outcome assessors.
Reporting Bias
- Occurs when there are systematic differences between reported and unreported findings.
- A distortion of presented information from research due to the selective disclosure or withholding of information by parties involved.
- How to avoid: Blinding (or masking) outcome assessors.
Conflict of Interest Bias
- A set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest.
- Examples: Financial (e.g., a company funding a trial of a drug produced by the same company) and non-financial (e.g., career advancement, publishable results, service to patients or students, fame, power, or family and friendships).
Traffic Light Graph for Systematic Literature Review
- Red means a high risk of bias, yellow means an unclear risk of bias, and green means a low risk of bias.
- A useful tool for telling the reader your assessment of each study reviewed.
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Description
Learn about the definition and sources of bias in research, including selection bias, and how to avoid it in randomized controlled trials.