Which of the following statements is not the accurate description of selection bias in case-control studies?

A) If cases are selected from a single hospital, any risk factors that are identified may be unique to that hospital.
B) If the hospital from which the cases are drawn is a tertiary care facility, any risk factors identified in the study may be risk factors only in persons with severe forms of the disease.
C) If hospitalized cases are to be used, it is desirable to select the cases from several hospitals in the community.
D) Using hospitalized patients as controls is the best way to characterize the reference population because they are a captive population and are clearly identified.
E) Best friends controls and neighborhood controls are examples of use of nonhospitalized people as controls.

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Masoumeh Soleymsni · Accepted Answer

Final Answer : D, Explanation :  Hospitalized patients represent a sample of an ill-defined reference population,not the general reference population.Moreover,hospital patients differ from people in the community.Therefore using hospitalized patients as controls is not the best way to characterize the reference population.The best way to characterize the reference population is using nonhospitalized people as controls with probability sampling from the community (but rarely possible).

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