Abstract
Background and objective
This study demonstrates the impact of survey nonresponse bias on conclusions from
a mammography trial targeting a disadvantaged population.
Methods
The trial randomized 1558 women to three interventions designed to promote repeat
mammography: mailed reminder (minimum group); mailed thank-you card, patient newsletters,
and reminder (maximum group); and no mailings (control group). The primary outcome,
repeat mammogram within 15 months, was assessed from administrative and phone survey
data.
Results
Administrative estimates revealed a statistically significant difference of 7% between
the maximum and control groups on the primary outcome. Survey estimates (response
rate 80%) revealed no significant differences. The differences by data source were
traced to a survey nonresponse bias. There was a statistically significant difference
of 16% between the maximum and control groups among survey nonrespondents for the
primary outcome, but there were no differences among survey respondents.
Conclusion
The findings reiterate that even a low survey nonresponse rate can bias study conclusions
and suggest studies targeting disadvantaged populations should avoid relying solely
on survey data for outcome analyses.
Keywords
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Article info
Publication history
Accepted:
February 12,
2003
Identification
Copyright
© 2003 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
