Late response to patient-reported outcome questionnaires after surgery was associated with worse outcome

Hutchings, A; Grosse Frie, KM; Neuburger, J; van der Meulen, J; Black, N; (2013) Late response to patient-reported outcome questionnaires after surgery was associated with worse outcome. Journal of clinical epidemiology, 66 (2). pp. 218-225. ISSN 0895-4356 DOI:

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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. (C) 2013 Elsevier Inc. All rights reserved.

Item Type: Article
Keywords: Adult, Aged, Arthroplasty, Replacement, Hip, adverse effects, methods, Arthroplasty, Replacement, Knee, adverse effects, methods, Bias (Epidemiology), Confidence Intervals, Cross-Sectional Studies, Female, Herniorrhaphy, adverse effects, methods, Humans, Male, Middle Aged, Odds Ratio, Patient Compliance, statistics & numerical data, Postoperative Complications, epidemiology, Quality of Life, Questionnaires, Self-Assessment, Surgical Procedures, Elective, adverse effects, methods, Time Factors, Treatment Outcome, Varicose Veins, surgery
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 23200295
Web of Science ID: 313378500014


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