Which of the following study designs is LEAST prone to incidence-prevalence bias (Neyman's bias)?

• A Cross-sectional study
• B Case-control study using prevalent cases
• C Retrospective case-control with prevalent cases
• D Prospective cohort study ✓

Explanation

Neyman's bias (incidence-prevalence bias) occurs when prevalent cases (survivors) are studied instead of incident (new) cases, leading to underestimation of rapidly fatal exposures and overrepresentation of benign cases. Prospective cohort studies capture incident cases as they develop in real time, minimizing this bias. Cross-sectional and case-control studies using prevalent cases are most susceptible because they miss cases who died or recovered before enrollment.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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