© 2009 American Public Health Association DOI: 10.2105/AJPH.2009.168427
Thomas M. Rice is with the Traffic Safety Center and the Department of Environmental Health Sciences, University of California, Berkeley. Craig L. Anderson is with the Center for Trauma and Injury Prevention Research and the Department of Emergency Medicine, University of California, Irvine. Correspondence: Correspondence should be sent to Thomas M. Rice, Traffic Safety Center, 2614 Dwight Way #7374, Berkeley, CA 94720-7374 (e-mail: tomrice@berkeley.edu). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.
Elliot et al. expressed their concern of selection bias owing to the inclusion of vehicles carrying 1 child with 1 or more adults in our study of child safety seat effectiveness.1 Elliot et al. point out that an assumption of similar underlying within-vehicle death risk is required. We examined this issue during the design of the matched-cohort study. We concluded that no bias would result because, after adjustment for seating position, gender, age splines, collision type, rollover status, and numerous "matched" factors like vehicle type and emergency vehicle response time, the assumption would be reasonable.
To examine this possible bias,
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