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This may mainly be due to a high selection bias and low response rates in mail surveys.
All these factors can produce high selection bias, performance bias and measuring bias.
For observational studies, three areas of potential bias were graded as low, unclear or high: selection bias, information bias and confounding.
Participation rate was high, selection bias limited, observation period long and the evaluation of morbidity changes was based on assessment of full-text hospital records.
Since our target population consists of patients who are high care users, who are more willing to participate than patients who receive for example assertive outreach [ 9], we do not expect high selection bias.
Since ascertainment of cases and controls in our study was high, selection bias may only explain our findings if the small proportion of non-participating cases were overwhelmingly drinkers of "cold tea" or, conversely, the non-participating controls were overwhelmingly drinkers of "hot tea".
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Even residues common in the population are less likely to be transmitted to healthy men than to women, indicative of higher selection bias in woman-to-man transmission.
However, most of the patients with peptic ulcer history in our region are infected with Helicobacter pylori and including such cases would have represented a higher selection bias.
The results also show that higher entry criteria, lower between-subject variances, and higher within-subject variances cause higher selection biases.
Most studies were rated high for selection bias.
Therefore, the prevalence of DM (24%) or CAD (48%) was quite high, and selection bias may affect the results.
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