Abstract
Objectives
Nonresponse to patient-reported outcome (PRO) questionnaires after surgery might bias
the results. Our aim was to gauge the potential impact of nonresponse bias by comparing
the outcomes of early and late responders.
Study Design and Setting
This study compares 59,565 early and 20,735 late responders who underwent a hip or
knee replacement, hernia repair, or varicose vein (VV) surgery. The association between
timeliness of response and three outcomes (the mean postoperative disease-specific
PRO and generic PRO scores and the proportion reporting a fair or poor result) was
examined by regression analysis.
Results
Late responders were slightly more likely to be young, nonwhite, deprived, and have
a more severe preoperative condition with poorer quality of life. Late response was
associated with a slightly poorer outcome in all four procedures although not statistically
significant (P < 0.05) for VV surgery. Adjusting for preoperative characteristics reduced the strength
of the associations, but they remained statistically significant.
Conclusion
As nonresponse to PRO questionnaires introduces slight bias, differences in response
rates between hospitals should be taken into account when making comparisons so as
to avoid overestimating the performance of those with lower response rates and failing
to detect poor performing hospitals.
Keywords
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Article info
Publication history
Published online: November 30, 2012
Accepted:
September 5,
2012
Footnotes
Conflict of interest statement: We have no conflict of interest.
This work was funded by the Department of Health for England.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
