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Recruitment bias in chronic pain research: whiplash as a model

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Abstract

In science findings which cannot be extrapolated to other settings are of little value. Recruitment methods vary widely across chronic whiplash studies, but it remains unclear whether this generates recruitment bias. The present study aimed to examine whether the recruitment method accounts for differences in health status, social support, and personality traits in patients with chronic whiplash-associated disorders (WAD). Two different recruitment methods were compared: recruiting patients through a local whiplash patient support group (group 1) and local hospital emergency department (group 2). The participants (n = 118) filled in a set of questionnaires: the Neck Disability Index, Medical Outcome Study Short-Form General Health Survey, Anamnestic Comparative Self-Assessment measure of overall well-being, Symptom Checklist-90, Dutch Personality Questionnaire, and the Social Support List. The recruitment method (either through the local emergency department or patient support group) accounted for the differences in insufficiency, somatization, disability, quality of life, self-satisfaction, and dominance (all p values <.01). The recruitment methods generated chronic WAD patients comparable for psychoneurotism, social support, self-sufficiency, (social) inadequacy, rigidity, and resentment (p > .01). The recruitment of chronic WAD patients solely through patient support groups generates bias with respect to the various aspects of health status and personality, but not social support. In order to enhance the external validity of study findings, chronic WAD studies should combine a variety of recruitment procedures.

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Acknowledgments

The study was funded by the Flemish Government (Steunpunt Verkeersveiligheid project number 1.4). Liesbeth Daenen is a research fellow of the University of Antwerp, Belgium. We also like to thank all the participants for providing the data. Special thanks to the (board) members of the vzw Whiplash (Belgian Support Group for patients with whiplash-associated disorders) for their cooperation.

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Authors and Affiliations

  1. Department of Human Physiology, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium

    Jo Nijs, Liesbeth Daenen & Nathalie Roussel

  2. Division of Musculoskeletal Physiotherapy, Department of Health Care Sciences, Artesis University College Antwerp, Antwerp, Belgium

    Jo Nijs, Liesbeth Daenen & Nathalie Roussel

  3. Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium

    Jo Nijs

  4. Human Ecology Department, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium

    Els Inghelbrecht, Luc Hens & Jan Bernheim

  5. Medical Sociology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium

    Els Inghelbrecht

  6. Department of Neurology, Faculty of Medicine, Antwerp University, Antwerp, Belgium

    Liesbeth Daenen, Nathalie Roussel & Patrick Cras

  7. Department of Critical Care Medicine, Vrije Universiteit Brussel, Brussels, Belgium

    Said Hachimi-Idrissi

  8. Cerebral Resuscitation Research Group, Vrije Universiteit Brussel, Brussels, Belgium

    Said Hachimi-Idrissi

  9. Provinciale Hogeschool Limburg, Hasselt, Belgium

    Bert Willems

  10. Department of Statistics, University Hospital Antwerp (UZA), Antwerp, Belgium

    Kristien Wouters

  11. Vrije Universiteit Brussel, Building L-Mfys, Pleinlaan 2, 1050, Brussels, Belgium

    Jo Nijs

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  1. Jo Nijs
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Correspondence to Jo Nijs.

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Nijs, J., Inghelbrecht, E., Daenen, L. et al. Recruitment bias in chronic pain research: whiplash as a model. Clin Rheumatol 30, 1481–1489 (2011). https://doi.org/10.1007/s10067-011-1829-8

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  • DOI: https://doi.org/10.1007/s10067-011-1829-8

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