The impact of survey nonresponse bias on conclusions drawn from a mammography intervention trial

Melissa R. Partin, Michael Malone, Mary Winnett, Jonathan Slater, Annette Bar-Cohen, Lee Caplan

Research output: Contribution to journalArticle

33 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)867-873
Number of pages7
JournalJournal of Clinical Epidemiology
Volume56
Issue number9
DOIs
StatePublished - Sep 1 2003

Keywords

  • Health education
  • Intervention studies
  • Mammography
  • Nonrespondents
  • Randomized controlled trial
  • Selection bias

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