To estimate the potential for response bias in standard mailed questionnaires used in surveys of GI symptoms in a community.
Subjects and methods
Validated self-report tools have been developed to measure functional gastrointestinal (GI) disorders but response rates in community surveys have been rapidly declining in many parts of the world. Whether a lower community response rate introduces significant response bias in GI survey research is unknown. A questionnaire was mailed to a total of 5,069 randomly selected subjects. The overall response rate was 52 %. A random sample of 723 of these subjects (428 responders and 295 non-responders, stratified by age and gender) was selected for medical record abstraction (including both inpatient and outpatient history).
The odds for response increased in those with a higher body mass index (odds ratio (OR):1.02 [95 % CI: 1.01, 1.03]), more health care seeking behavior for non-GI problems (OR: 1.97 [95 % CI: 1.43, 2.72]), and for those who had responded to a previous survey (OR: 4.84 [95 % CI: 2.84, 8.26]). Responder status was not significantly associated with any GI symptoms or a diagnosis of GI or non-GI disease (with two exceptions, diverticulosis and skin disease).
Despite a response rate of only 52 %, the results of a community-based GI survey do not appear to be impacted by non-response bias in a major way. A low survey response rate does not necessarily indicate non-response bias.
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The authors wish to thank Johannes von Blumenthal, who was a medical student of Paracelsus Medizinische Privatuniversitat, Austria, for his assistance with the chart reviews.
This study was made possible in part by the Rochester Epidemiology Project (Grant no. R01-AR30582 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases).
Conflict of Interest
The authors declare they have no conflict of interest.
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Choung, R.S., Locke, G.R., Schleck, C.D. et al. A low response rate does not necessarily indicate non-response bias in gastroenterology survey research: a population-based study. J Public Health 21, 87–95 (2013). https://doi.org/10.1007/s10389-012-0513-z
- Gastrointestinal surveys