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Late-entry bias does exist in this patient population. The figure shows age at clinic enrolment, with SS disease patients identified as the white curve, and three other SCD genotypes (other forms of sickle cell disease) as gray curves. Median clinic enrolment is approximately 13 years of age for SS patients (and later for the other sickle hemoglobin disorders).

This late-entry effect will inevitably occur when using a clinic-population, and the methods we use to cope with such a bias are now explored.