Bias | Effect | How to avoid |
Lead time | Appears to improve survival time but actually increases "disease" time after disease detection. | Use mortality rather than survival rates. |
Length time | Outcome appears better in screened group because more cancers with a good prognosis are detected. | Compare outcomes in randomized controlled trial with control group and one offered screening. Count all outcomes regardless of method of detection. |
Compliance | Outcome in screened group appears better due to compliance, not screening. | Compare outcomes in randomized controlled trial with control group and one offered screening. Count all outcomes regardless of compliance. |
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