Berkson's bias is a type of selection bias that occurs specifically in:
- A Hospital-based case-control studies due to differential hospitalization rates ✓
- B Cohort studies where loss to follow-up is differential
- C Cross-sectional studies with low response rates
- D Randomized controlled trials with unblinded allocation
Correct answer: A. Hospital-based case-control studies due to differential hospitalization rates
Explanation
Berkson's bias (also called admission rate bias) occurs in hospital-based case-control studies when the combined effect of exposure and disease on hospitalization differs from either alone, leading to a non-representative control group. People with both the exposure and another condition are more likely to be hospitalized, distorting the apparent exposure-outcome association.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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