Improving response rates and evaluating nonresponse bias in surveys: AMEE Guide No. 102

BackgroundCauda equina syndrome (CES) is a rare neurologic complication of lumbar herniated disc for which emergency surgical decompression should be undertaken. Despite the common belief that the restoration of functions that are affected by CES can take several years postoperatively, follow up seldom exceeds the first year after surgery. Long term outcome of especially micturition, defecation and sexual function—which are by definition affected in CES—are unknown. The aim of this study is to evaluate 1) postoperative long term outcome of micturition, defecation and sexual function in CES patients 2) attitude of patients towards received hospital care with regard to (recovery of) these functions.MethodsCES patients were selected by screening the records of all patients operated on lumbar herniated disc in our university hospital between 1995–2010. A questionnaire was sent to the selected CES patients evaluating current complaints of micturition, defecation and sexual function and attitude towards delivered care with focus on micturition, defecation and sexual function.ResultsThirty-seven of 66 eligible CES patients were included (response rate 71%, inclusion rate 56%). Median time after surgery was 13.8 years (range 5.8–21.8 years). Dysfunction at follow up was highly prevalent: 38% micturition dysfunction, 43% defecation dysfunction and 54% sexual dysfunction. Younger age at presentation was associated with sexual dysfunction at follow up: for every year younger at presentation, odds ratio for sexual dysfunction at follow up was 1.11 (p = 0.035). Other associations with outcome were not identified. Two-third of the CES patients wished their neurosurgeon had given them more prognostic information about micturition, defecation and sexual function.ConclusionThe presented data demonstrate that dysfunction of micturition, defecation and sexual function are still highly prevalent in a large number of CES patients even years postoperatively. These alarming follow up data probably have a devastating effect on personal perceived quality of life, which should be studied in more detail. CES patients communicate a clear demand for more prognostic information. The presented figures enable clinicians to inform their CES patients more realistically about long term postoperative outcome of micturition, defecation and sexual function after surgical intervention.

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“…Baseline characteristics of responders and non responders were not significantly different, making response bias unlikely. [40]…”

Section: Discussionmentioning

confidence: 99%

The long term outcome of micturition, defecation and sexual function after spinal surgery for cauda equina syndrome

et al. 2017

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“…Given that 6,120 were randomly selected from among 8,000 potential participants, demonstration that 484 responses were representative and not associated with bias was undertaken applying non response analysis. Wave analysis 27 as the surrogate approach for analyzing non-response was applied, comparing responses of participants across both demographic and topical domains of the survey differentiated by temporality of the response. No statistically significant difference was detected among the survey responses between surveys distributed in the initial mailing and those distributed in subsequent mailing, reflecting no detection of bias.…”

Section: Discussionmentioning

confidence: 99%

Statistical Application and Cost Saving in a Dental Survey

et al. 2017

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Objective: To effectively achieve a robust survey response rate in a timely manner, an alternative approach to survey distribution, informed by statistical modeling, was applied to efficiently and cost-effectively achieve the targeted rate of return. Design:A prospective environmental scan surveying adoption of health information technology utilization within their practices was undertaken in a national pool of dental professionals (N=8000) using an alternative method of sampling. The piloted approach to rate of cohort sampling targeted a response rate of 400 completed surveys from among randomly targeted eligible providers who were contacted using replicated subsampling leveraging mailed surveys. Methods:Two replicated subsample mailings (n=1000 surveys/mailings) were undertaken to project the true response rate and estimate the total number of surveys required to achieve the final target. Cost effectiveness and non-response bias analyses were performed. Results:The final mailing required approximately 24% fewer mailings compared to targeting of the entire cohort, with a final survey capture exceeding the expected target. An estimated $5000 in cost savings was projected by applying the alternative approach. Non-response analyses found no evidence of bias relative to demographics, practice demographics, or topically-related survey questions. Conclusion:The outcome of this pilot study suggests that this approach to survey studies will accomplish targeted enrollment in a cost effective manner. Future studies are needed to validate this approach in the context of other survey studies.

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“…To avoid non-response bias, we made attempts to enhance the response rate by offering financial incentives, sending frequent reminders, and using diverse formats – paper-based and online-based surveys – as suggested by Phillips et al [12]. …”

Section: Methodsmentioning

confidence: 99%

The gap between medical faculty’s perceptions and use of e-learning resources

Kim

Kang

Kim

2017

Medical Education Online

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Background: e-Learning resources have become increasingly popular in medical education; however, there has been scant research on faculty perceptions and use of these resources.Objective: To investigate medical faculty’s use of e-learning resources and to draw on practical implications for fostering their use of such resources.Design: Approximately 500 full-time faculty members in 35 medical schools across the nation in South Korea were invited to participate in a 30-item questionnaire on their perceptions and use of e-learning resources in medical education. The questionnaires were distributed in both online and paper formats. Descriptive analysis and reliability analysis were conducted of the data.Results: Eighty faculty members from 28 medical schools returned the questionnaires. Twenty-two percent of respondents were female and 78% were male, and their rank, disciplines, and years of teaching experience all varied. Participants had positive perceptions of e-learning resources in terms of usefulness for student learning and usability; still, only 39% of them incorporated those resources in their teaching. The most frequently selected reasons for not using e-learning resources in their teaching were ‘lack of resources relevant to my lectures,’ ‘lack of time to use them during lectures,’ and ‘was not aware of their availability.’Conclusions: Our study indicates a gap between medical faculty’s positive perceptions of e-learning resources and their low use of such resources. Our findings highlight the needs for further study of individual and institutional barriers to faculty adoption of e-learning resources to bridge this gap.

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Improving response rates and evaluating nonresponse bias in surveys: AMEE Guide No. 102

Cited by 208 publications

References 32 publications

The long term outcome of micturition, defecation and sexual function after spinal surgery for cauda equina syndrome

The long term outcome of micturition, defecation and sexual function after spinal surgery for cauda equina syndrome

Statistical Application and Cost Saving in a Dental Survey

The gap between medical faculty’s perceptions and use of e-learning resources

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