Identifying and mitigating bias in multiple aspects of modern clinical research

In clinical research, bias is a systematic error that creates a difference between observed and true values. The increasing use of large datasets and artificial intelligence (AI) in medicine necessitates a renewed focus on how such errors can be introduced and propagated.This educational primer provides a consolidated framework of the three primary types of bias selection, information, and confounding/analytical. We synthesize these concepts for an interdisciplinary audience of clinicians and data scientists, using illustrative examples from both traditional clinical trials and modern, data-intensive research. Bias can arise at every stage of the research lifecycle: design, conduct, analysis, reporting, and dissemination. We illustrate how classic issues, such as selection bias (systematic differences between those included and those eligible/targeted, thus distorting effect estimates), manifest in data and how modern analytical methods can introduce novel forms of error if not carefully managed. A shared understanding of bias is essential for effective collaboration between clinical and data science teams. This primer offers a practical conceptual map to help these teams proactively identify, mitigate, and transparently report on potential sources of bias, ultimately fostering more robust and equitable clinical evidence.