Question
In the early 1980s, studies demonstrated that women who used tampons for menstrual protection were at increased risk of developing Toxic Shock Syndrome (TSS). The cumulative incidence of menstrual TSS today is estimated to be in the range of 1 to 3 per 100,000 women per year. Studies have shown that the risk of tampon-associated TSS is a function of the absorption and chemical composition of the tampons used. Since this finding was published, tampons have changed substantially in their chemical composition and absorption, and it is unknown whether tampons being sold and used today cause an increased risk of menstrual TSS.
A. If asked to design an epidemiologic study of the association between tampon use and menstrual TSS today, what study design would you choose and why?
B. What are potential sources of selection bias in this study?
C. What are potential sources of information bias in this study?
D. Name 5 ways to reduce bias during the design and implementation of a study.
