Systematic review reveals significant differences between consenting and non-consenting individuals, indicating mandatory consent can induce selection bias in observational research.
Significant differences between participants and non-participants may threaten the validity of results from observational studies that require consent for use of data from medical records. To ensure that legislation on privacy does not unduly bias observational studies using medical records, thoughtful decision making by research ethics boards on the need for mandatory consent is necessary.
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Kho et al. (2009) studied this question.
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