Evaluating non-responders of a survey in the Swedish fracture register: no indication of different functional result

Abstract

BackgroundThe Swedish Fracture Register (SFR) currently contains information on more than 190,000 fractures. Patient Reported Outcome Measures (PROMs) are used for monitoring functional results after fracture treatment. One weakness, as in many surveys, is a low response rate. The aim of the current study was to examine if non-responders of a survey in the SFR differ in PROMs scores, how age and gender influence the response rate and reasons for not responding.MethodsPatients with fractures of radius, ulna or humerus between June and August 2013 and registered in the SFR were included in the study. The non-responders to both the pre-injury and the 1-year survey were contacted by phone and reminded to reply. A comparison of the results of both EQ-5D and Short Musculoskeletal Function Assessment (SMFA) could be made between the responders after a phone reminder and the initial responders. The response rate for the register as a whole was extracted in order to identify how age and gender affect the response rate.ResultsThree hundred seventeen of the patients included in the study responded initially. After phone reminder another 94 patients answered the pre-injury survey. Two hundred sixty eight responded initially to the 1-year follow-up survey and 42 after phone reminder. No significant difference was identified in the score of the pre-injury survey between initial responders and responders after phone reminder neither in the EQ-5D nor in the Short Musculoskeletal Function Assessment (SMFA). Regarding the 1-year survey, responders after a phone reminder reported a significantly better outcome in crude data of SMFA score. This difference disappeared after controlling for confounding factors through case control matching. The highest response rate to PROMs in the SFR was among females in the age range 60–69 years.ConclusionThis study indicates that both in the preinjury survey as well as in the 1-year survey the non-responders in the SFR report similar function compared to the initial responders. Age and gender of patients affect the response rate of the survey which needs to be taken into consideration in analysis of data from the SFR.

Characteristics and predicted outcome of patients lost to follow-up after degenerative lumbar spine surgery

“…According to the current study, respondents are of older age, more often born inside of the EU, have a higher socioeconomic status, a better baseline health status and less adverse events, compared to non-respondents. The differences between respondents and non-respondents in age, sex, smoking, level of education and income confirm the results of previous studies [3,[12][13][14]. Younger individuals were more likely to be non-respondents, which may reflect a lack of time because of work and family life.…”

Epidemiology and incidence of tibia fractures in the Swedish Fracture Register

“…The SFR and its users share responsibility for ensuring that data are entered in an appropriate manner. Study II in this thesis, as well as the other validity studies that have been conducted, was required for the data in the SFR to be regarded as reliable and useful [80][81][82][83][84] . As will be discussed in the context of the validity of the classification of tibial fractures later in this thesis, the accuracy of fracture classification is not perfect in any way.…”

Review of response rates over time in registry-based studies using patient-reported outcome measures

“…Previous studies have demonstrated that age, gender and other factors such as socioeconomic status affect RRs. [12][13][14] Furthermore, studies have indicated that patients with higher health-related quality of life scores and satisfaction may be over-represented in PROM studies, even in studies with relatively high RRs. 15 16 These potential selection and attrition biases can affect the resulting estimate of the treatment effect, especially in registries that collect data over multiple time points.…”