Healthy user bias

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The healthy user bias is a bias that can damage the validity of epidemiologic studies testing the efficacy of particular therapies or interventions. Specifically, it is a sampling bias: the kind of subjects that voluntarily enroll in a clinical trial and actually follow the experimental regimen are not representative of the general population. They can be expected, on average, to be healthier as they are concerned for their health and are predisposed to follow medical advice,[1] both factors that would aid one's health. In a sense, being healthy or active about one's health is a precondition for becoming a subject of the study, an effect that can appear under other conditions such as studying particular groups of workers (i.e. someone in ill health is unlikely to have a job as manual laborer).


  1. ^ Shrank, William H.; Patrick, Amanda R.; Alan Brookhart, M. (May 2011). "Healthy User and Related Biases in Observational Studies of Preventive Interventions: A Primer for Physicians". Journal of General Internal Medicine. 26 (5): 546–550. doi:10.1007/s11606-010-1609-1. ISSN 0884-8734. PMC 3077477. PMID 21203857.

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