{"id":5988,"date":"2018-07-02T06:06:15","date_gmt":"2018-07-02T10:06:15","guid":{"rendered":"https:\/\/first10em.com\/?p=5988"},"modified":"2021-06-08T16:26:28","modified_gmt":"2021-06-08T20:26:28","slug":"bias","status":"publish","type":"post","link":"https:\/\/first10em.com\/bias\/","title":{"rendered":"Bias in medical research"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">A bias in evidence based medicine is any factor that leads to conclusions that are systematically different from the truth.\u00a0<\/span><!--more--><\/p>\n<p><span style=\"font-weight: 400;\">Bias is universal. Some study designs are better than others, but there is no perfect study. Although in general parlance \u201cbias\u201d has moral or ethical implications, research bias does not refer to the researcher\u2019s character, just the validity of the study. (I do not include fraud as a type of research bias, but it is important to be aware that the medical literature is full of examples of both major and minor research fraud.)<\/span><\/p>\n<p>Bias is not something that can be accounted for with statistics. Larger sample sizes will can create more precision, but that doesn&#8217;t help if the numbers aren&#8217;t accurate. Ideally, we want to see research that is both precise and accurate, but I would take accurate over precise any day.<\/p>\n<p><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" data-attachment-id=\"5991\" data-permalink=\"https:\/\/first10em.com\/bias\/accurate-precist-first10em\/\" data-orig-file=\"https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Accurate-Precist-First10EM.png\" data-orig-size=\"1024,345\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"Accurate Precist First10EM\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Accurate-Precist-First10EM.png\" class=\"alignnone size-full wp-image-5991\" src=\"https:\/\/i0.wp.com\/first10em.com\/wp-content\/uploads\/2018\/06\/Accurate-Precist-First10EM.png?resize=1140%2C384&#038;ssl=1\" alt=\"Accurate Precist First10EM.png\" width=\"1140\" height=\"384\" \/><\/p>\n<p><span style=\"font-weight: 400;\">I really believe that <a href=\"https:\/\/first10em.com\/ebmiseasy\/\">evidence based medicine is easy<\/a>. Most types of research bias are actually quite easy to understand. Unfortunately, critical appraisal novices are frequently scared off by the sheer number of biases and the technical jargon that is often used to describe them. For that reason, I have started this glossary of research biases.\u00a0<\/span><\/p>\n<h2><b>Bias Glossary<\/b><\/h2>\n<p><a href=\"https:\/\/first10em.com\/ebm\/allocation-bias\/\"><span style=\"font-weight: 400;\">Allocation bias<\/span><\/a><\/p>\n<p><span style=\"font-weight: 400;\"><a href=\"http:\/\/first10em.com\/ebm\/ascertainment-bias\/\">Ascertainment bias<\/a><\/span><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/hawthorne-effect\/\"><span style=\"font-weight: 400;\">Attention bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/attrition-bias\/\"><span style=\"font-weight: 400;\">Attrition bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/chronological-bias\/\"><span style=\"font-weight: 400;\">Chronological bias<\/span><\/a><\/p>\n<p><a href=\"http:\/\/first10em.com\/ebm\/co-intervention-bias\/\"><span style=\"font-weight: 400;\">Co-intervention bias<\/span><\/a><\/p>\n<p><a href=\"http:\/\/first10em.com\/ebm\/contamination-bias\/\"><span style=\"font-weight: 400;\">Contamination bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/diagnostic-access-bias\/\"><span style=\"font-weight: 400;\">Diagnostic access bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/diagnostic-suspicion-bias\/\"><span style=\"font-weight: 400;\">Diagnostic suspicion bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/measurement-bias\/\"><span style=\"font-weight: 400;\">Detection bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/unmasking-bias\/\">Detection-signal bias<\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/expectation-bias\/\"><span style=\"font-weight: 400;\">Expectation bias<\/span><\/a><\/p>\n<p><a href=\"http:\/\/first10em.com\/ebm\/intervention-bias\/\"><span style=\"font-weight: 400;\">Exposure bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/hawthorne-effect\/\"><span style=\"font-weight: 400;\">Hawthorne effect<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/incorporation-bias\/\"><span style=\"font-weight: 400;\">Incorporation bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/inflation-bias\/\">Inflation bias<\/a><\/p>\n<p><a href=\"http:\/\/first10em.com\/ebm\/insensitive-measurement-bias\/\"><span style=\"font-weight: 400;\">Insensitive measurement bias<\/span><\/a><\/p>\n<p><a href=\"http:\/\/first10em.com\/ebm\/intervention-bias\/\"><span style=\"font-weight: 400;\">Intervention bias<\/span><\/a><\/p>\n<p><span style=\"font-weight: 400;\"><a href=\"https:\/\/first10em.com\/ebm\/lead-time-bias\/\">Lead time bias<\/a><\/span><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/measurement-bias\/\"><span style=\"font-weight: 400;\">Measurement bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/membership-bias\/\"><span style=\"font-weight: 400;\">Membership bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/prevalence-incidence-bias\/\">Neyman bias<\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/response-bias\/\"><span style=\"font-weight: 400;\">Non-respondent bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/observer-bias\/\"><span style=\"font-weight: 400;\">Observer bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/prevalence-incidence-bias\/\"><span style=\"font-weight: 400;\">Prevalence-incidence bias<\/span><\/a><\/p>\n<p><a href=\"http:\/\/first10em.com\/ebm\/proficiency-bias\/\"><span style=\"font-weight: 400;\">Proficiency bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/publication-bias\/\"><span style=\"font-weight: 400;\">Publication bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/recall-bias\/\"><span style=\"font-weight: 400;\">Recall bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/referral-bias\/\"><span style=\"font-weight: 400;\">Referral bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/reporting-bias\/\"><span style=\"font-weight: 400;\">Reporting bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/response-bias\/\"><span style=\"font-weight: 400;\">Response bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/sampling-bias\/\"><span style=\"font-weight: 400;\">Sampling bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/selection-bias\/\"><span style=\"font-weight: 400;\">Selection bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/spectrum-bias\/\"><span style=\"font-weight: 400;\">Spectrum bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/survival-bias\/\"><span style=\"font-weight: 400;\">Survival bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/time-lag-bias\/\"><span style=\"font-weight: 400;\">Time lag bias<\/span><\/a><\/p>\n<p><a href=\"http:\/\/first10em.com\/ebm\/timing-bias\/\"><span style=\"font-weight: 400;\">Timing bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/unmasking-bias\/\"><span style=\"font-weight: 400;\">Unmasking bias<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/verification-bias\/\"><span style=\"font-weight: 400;\">Verification bias (or partial verification bias)<\/span><\/a><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/response-bias\/\"><span style=\"font-weight: 400;\">Volunteer bias<\/span><\/a><\/p>\n<p><span style=\"font-weight: 400;\">There is no official list of research biases to refer to. As a consequence, a number of these terms are used differently by different people. I have included competing definitions wherever I found them.\u00a0<\/span><span style=\"font-weight: 400;\">If there are other research biases that you think should be included, or have suggestions to improve this resource, <\/span><a href=\"https:\/\/first10em.com\/contact\/\"><span style=\"font-weight: 400;\">please let me know<\/span><\/a><span style=\"font-weight: 400;\">. <\/span><\/p>\n<p><a href=\"https:\/\/first10em.com\/ebm\/\"><span style=\"font-weight: 400;\">More evidence based medicine resources can be found here<\/span><\/a><span style=\"font-weight: 400;\">. <\/span><\/p>\n<div class=\"boxed\" style=\"text-align: left;\">\n<p><span style=\"font-weight: 400;\"><strong>Key Point:<\/strong> The existence of research bias does not indicate wrongdoing on behalf of the researchers. For example, a researcher could run a methodologically perfect weight loss trial, but because people that volunteer for such trials are systematically different from the general population, the results could be impacted by selection bias, limiting the generalizability of the results. <\/span><\/p>\n<\/div>\n<h2><b>Other Resources<\/b><\/h2>\n<span class=\"embed-youtube\" style=\"text-align:center; display: block;\"><iframe loading=\"lazy\" class=\"youtube-player\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/EOXBlgMEqB0?version=3&#038;rel=0&#038;showsearch=0&#038;showinfo=1&#038;iv_load_policy=1&#038;fs=1&#038;hl=en-US&#038;autohide=2&#038;wmode=transparent\" allowfullscreen=\"true\" style=\"border:0;\" sandbox=\"allow-scripts allow-same-origin allow-popups allow-presentation allow-popups-to-escape-sandbox\"><\/iframe><\/span>\n<p>(Lots of other great videos on\u00a0<a href=\"http:\/\/www.sketchyebm.com\/\">http:\/\/www.sketchyebm.com\/<\/a>)<\/p>\n<p><a href=\"http:\/\/www.jameslindlibrary.org\/topics\/\"><span style=\"font-weight: 400;\">http:\/\/www.jameslindlibrary.org\/topics\/<\/span><\/a><\/p>\n<p><a href=\"https:\/\/catalogofbias.org\/\"><span style=\"font-weight: 400;\">https:\/\/catalogofbias.org\/<\/span><\/a><\/p>\n<h2><b>References<\/b><\/h2>\n<p><span style=\"font-weight: 400;\">Sackett DL. Bias in analytic research. Journal of chronic diseases. 1979; 32(1-2):51-63. PMID: <\/span><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/447779\"><span style=\"font-weight: 400;\">447779<\/span><\/a><\/p>\n<div class=\"wpcp\"><center><strong>Cite this article as:<\/strong><br>\r\nMorgenstern, J. Bias in medical research, First10EM, \r\nJuly 2, 2018. Available at:<br> <a href=\"https:\/\/doi.org\/10.51684\/FIRS.5988\">https:\/\/doi.org\/10.51684\/FIRS.5988<\/a><\/center><\/div>\n","protected":false},"excerpt":{"rendered":"<p>A glossary of common research biases<\/p>\n","protected":false},"author":1,"featured_media":5989,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","_crdt_document":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"_wpas_customize_per_network":false,"jetpack_post_was_ever_published":false},"categories":[37375,596377654],"tags":[],"class_list":{"0":"post-5988","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-all-posts","8":"category-ebmcategory","9":"czr-hentry"},"featured_image_urls_v2":{"full":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",1024,576,false],"thumbnail":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",270,152,false],"medium":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",350,197,false],"medium_large":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",768,432,false],"large":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",1024,576,false],"1536x1536":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",1024,576,false],"2048x2048":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",1024,576,false],"newspack-article-block-landscape-large":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",1024,576,false],"newspack-article-block-portrait-large":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",900,506,false],"newspack-article-block-square-large":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",1024,576,false],"newspack-article-block-landscape-medium":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",800,450,false],"newspack-article-block-portrait-medium":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",600,338,false],"newspack-article-block-square-medium":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",800,450,false],"newspack-article-block-landscape-intermediate":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",600,338,false],"newspack-article-block-portrait-intermediate":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",450,253,false],"newspack-article-block-square-intermediate":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",600,338,false],"newspack-article-block-landscape-small":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",400,225,false],"newspack-article-block-portrait-small":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",300,169,false],"newspack-article-block-square-small":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",400,225,false],"newspack-article-block-landscape-tiny":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",200,113,false],"newspack-article-block-portrait-tiny":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",150,84,false],"newspack-article-block-square-tiny":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",200,113,false],"newspack-article-block-uncropped":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",1024,576,false],"tc-grid-full":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",789,444,false],"tc-grid":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",570,321,false],"tc-thumb":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",270,152,false],"slider-full":["https:\/\/first10em.com\/wp-content\/uploads\/2018\/06\/Research-Bias-title-First10EM.png",889,500,false],"slider":["https:\/\/first1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glossary of common research biases<\/p>\n","category_list_v2":"<a href=\"https:\/\/first10em.com\/all-posts\/\" rel=\"category tag\">All posts<\/a>, <a href=\"https:\/\/first10em.com\/ebmcategory\/\" rel=\"category tag\">Evidence Based Medicine<\/a>","author_info_v2":{"name":"Justin Morgenstern","url":"https:\/\/first10em.com\/author\/first10em\/"},"comments_num_v2":"8 comments","yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Bias in medical research - First10EM<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/first10em.com\/bias\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Bias in medical research - First10EM\" \/>\n<meta property=\"og:description\" content=\"A glossary of 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