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J Dent Res 84(10):942-946, 2005
© 2005 International and American Associations for Dental Research


RESEARCH REPORT
Clinical

Addressing Selection Bias in Dental Health Services Research

J.Y. Lee1,2,*, R.G. Rozier2, E.C. Norton2, and W.F. Vann, Jr.1

1 Department of Pediatric Dentistry, School of Dentistry, CB 7450 Brauer Hall, and 2 Department of Health Policy and Administration, School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7450, USA;

* corresponding author, jessica_lee{at}dentistry.unc.edu

When randomization is not possible, researchers must control for non-random assignment to experimental groups. One technique for statistical adjustment for non-random assignment is through the use of a two-stage analytical technique. The purpose of this study was to demonstrate the use of this technique to control for selection bias in examining the effects of the The Supplemental Program for Women, Infants, and Children’s (WIC) on dental visits. From 5 data sources, an analysis file was constructed for 49,512 children ages 1–5 years. The two-stage technique was used to control for selection bias in WIC participation, the potentially endogenous variable. Specification tests showed that WIC participation was not random and that selection bias was present. The effects of the WIC on dental use differed by 36% after adjustment for selection bias by means of the two-stage technique. This technique can be used to control for potential selection bias in dental research when randomization is not possible.

KEY WORDS: dental use • selection bias • endogeneity • WIC • non-randomization







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