The influence of completing a health-related questionnaire on primary care consultation behaviour

Jeffery, Amanda; Jinks, Clare; Jordan, Kelvin P.

doi:10.1186/1472-6963-6-101

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…Previous studies have found that survey responders with the topic under investigation are more likely to consent to medical record access [39]–[41] or to consult [17]; however, there is also evidence that survey participants do not change their consulting behaviour after completing a health-related questionnaire [42]. By contrast, the evidence for differences in health between participants and non-participants in cohort studies of older adults shows that non-participation at follow-up is more likely in those reporting poorer health [4], [9], [12] and cognitive impairment [4], [10], [11], [43], which provides one explanation of the finding that baseline participants had been less likely to consult about depression.…”

Section: Discussionmentioning

confidence: 99%

Does Attrition during Follow-Up of a Population Cohort Study Inevitably Lead to Biased Estimates of Health Status?

2013

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Attrition is a potential source of bias in cohort studies. Although attrition may be inevitable in cohort studies of older people, there is little empirical evidence as to whether bias due to such attrition is also inevitable. Anonymised primary care data, routinely collected in clinical practice and independent of any cohort research study, represents an ideal unselected comparison dataset with which to compare primary care data from consenting responders to a cohort study. Our objective was to use this method as a novel means to assess if (i) responders at follow-up stages in a cohort study remain representative of responders at baseline and (ii) attrition biases estimates of longitudinal associations. We compared primary care consultation morbidities and prescription prevalences among circa 32,000 patients aged 50+ who contribute to an anonymised general practice database (Consultations in Primary Care Archive (CiPCA)) with those from patients aged 50+ in the North Staffordshire Osteoarthritis Project (NorStOP) cohort, United Kingdom (2002–2008; n = 16,159). 8,197 (51%) persons responded to the NorStOP baseline survey and consented to medical record review. 5,121 and 3,311 responded at 3- and 6-year follow-ups. Differences in consulting prevalence of non-musculoskeletal morbidities between NorStOP responders and CiPCA comparison population did not increase over the two follow-up points except for ischaemic heart disease. Differences observed at baseline for osteoarthritis-related consultations were generally unchanged at the two follow-ups (standardised prevalence ratios for osteoarthritis (1.09–1.13) and joint pain (1.12–1.23)). Age and gender adjusted associations between baseline consultation for chronic morbidity and future new osteoarthritis and related consultations were similar in CiPCA (adjusted Hazard Ratio: 1.40; 95% Confidence Interval: 1.34,1.47) and NorStOP 6-year responders (1.32; 1.15,1.51). There was little evidence that responders at follow-ups represented any further selection bias to that present at baseline. Attrition in cohort studies of older people does not inevitably indicate bias.

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Section: Discussionmentioning

confidence: 99%

Does Attrition during Follow-Up of a Population Cohort Study Inevitably Lead to Biased Estimates of Health Status?

2013

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“…Previously it has been shown that postal surveys have no effect on subsequent consultation rates, either for the problem under focus or for other problems. 23 Further, people consenting to record review in this study had similar consultation rates to their whole-practice population. 24 Standardising the prevalence of insomnia for age and sex did not change observed rates, 1 and, while any selective non-response may affect the overall estimates of rates of consultation and prescription, the study's central analysis (the strength of association between baseline survey characteristics and subsequent consultation) is unlikely to be affected by any selection differences between participants, nonresponders, and non-consenters.…”

Section: Strengths and Limitations Of The Studymentioning

confidence: 84%