Berkson's bias is a systematic error that occurs specifically in which type of epidemiological study?
- A Hospital-based case-control studies due to differential hospitalization rates ✓
- B Prospective cohort studies due to loss to follow-up
- C Cross-sectional studies due to non-response bias
- D Randomized controlled trials due to allocation concealment failure
Correct answer: A. Hospital-based case-control studies due to differential hospitalization rates
Explanation
Berkson's bias (hospital admission bias) occurs in hospital-based case-control studies because people with multiple diseases are more likely to be hospitalized, leading to a spurious association between exposure and disease. It arises because cases and controls are both selected from a hospitalized population, distorting the true exposure-disease relationship in the general population.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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