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PubMed2005

American Brachytherapy Society survey regarding practice patterns of postoperative irradiation for endometrial cancer: current status of vaginal brachytherapy.

PURPOSE: To survey the current postoperative recommendations for radiotherapy (RT) in patients with endometrial cancer, with an emphasis on vaginal brachytherapy (VBT). METHODS AND MATERIALS: In August 2003, a 32-item questionnaire was mailed to a random sample of 2396 members of the American Society for Therapeutic Radiology and Oncology and the American Brachytherapy Society. The sample excluded members-in-training, physicists, and non-U.S. members. A follow-up mailing was conducted in November 2003. Those who had not treated any patient in the previous year for endometrial carcinoma were instructed to indicate so at the beginning of the questionnaire and return it without responding to any other item. Responses were tabulated to determine the relative frequency distribution. RESULTS: of the 2396 surveys sent out, 757 were returned, for a response rate of 31.6%. Of those who responded, 551 (72.8%) had performed postoperative irradiation for endometrial cancer and were included in this study. Of the 551 respondents, 99.8% had delivered external beam RT to some endometrial cancer patients. An increasing trend was found toward referrals for VBT; 91.5% of those who treated endometrial cancer performed VBT. The vaginal target most often irradiated was the upper vagina in 40.7%, upper 4-5 cm in 54.5%, and the entire vagina in 4.9%; 21.3% placed clips at the vaginal apex for applicator verification. The maximal dose to the bladder and rectum was recorded in 78.3% and 80.2% of patients, respectively. Of the respondents, 40% did not use low-dose-rate (LDR) VBT. The two most common LDR applicators were Delclos cylinders (29.7%) and Fletcher colpostats (29.3%). The mean boost dose delivered with LDR VBT when prescribed to the surface was 29.9 Gy and when prescribed to 0.5 cm was 23.8 Gy. When LDR therapy was used without external beam RT, the mean dose when prescribed to the surface was 56.8 Gy and when prescribed to 0.5 cm was 47.9 Gy. In 2002, 69.1% of respondents treated patients with high-dose-rate (HDR) VBT. Of the respondents, 90.6% used a single-channel vaginal cylinder, and 83.3% of cylinder users followed the curve of the cylinder to optimize dose, 67.9% adjusted the applicator position based on localization films, and 47% adjusted the applicator to be horizontal. The most common fractionation scheme when using HDR VBT as a boost was 5 Gy in three fractions prescribed to 0.5 cm (42.9%). The most common fractionation scheme used with HDR without external beam RT was 7 Gy in three fractions prescribed to 0.5 cm (41.8%). CONCLUSION: VBT is a common recommendation for postoperative adjuvant therapy for endometrial cancer. HDR appears to be the most popular approach, with a wide variety of dose fractionation schemes reported. Additional study is warranted to help define the ideal use of VBT.

Brachytherapy↗
PubMed1996

Physicians' attitudes toward clinical trials and their relationship to patient accrual in a Nordic multicenter study on myeloma.

Ninety-nine physicians participating in a Nordic multicenter trial on myeloma in 1990-1994 were surveyed, by means of a mailed questionnaire, with respect to their attitudes toward clinical trials and their opinions regarding the importance of certain factors influencing patient accrual. The inclusion rate of each participating clinic was recorded. Questions related to attitudes of presumed importance for patient accrual were analyzed for associations between the response distribution and the inclusion rate for the corresponding clinics. Ninety-three of the surveyed physicians responded to the questionnaire. The survey indicated that the physicians considered the scientific purpose of a trial to be the most important factor for patient accrual, followed by the simplicity of study protocol, the rightness of ethical aspects, the quality of communication with the study organization, and the degree of participation in investigators' meetings. A positive correlation to patient accrual was found for several attitudes held by the participating physicians, including their perception of the importance of a quality-of-life study in the protocol, their conception of the simplicity of the study protocol, their frequency of participation in investigators' meetings, and their awareness of cost and reimbursement levels for entered patients.

Attitude of Health Personnel↗
PubMed1999

Controversies and consensus in the diagnosis, work-up and treatment of gastric lymphoma: an international survey.

BACKGROUND: Variations in diagnostic criteria and staging procedures in cancer patients have important consequences for patient selection and often preclude meaningful comparison of published series. In gastric lymphoma, these effects will play a role, since diagnostic criteria are controversial. Moreover, staging procedures and therapeutic choices are influenced by insights from different clinical specialisms. METHODS: To review the management of gastric lymphoma, formatted questionnaires were mailed to leading institutes with a special interest in this field in Europe, the United States and Japan. RESULTS: Nineteen centers agreed to contribute. Minimum histological criteria varied among pathologists with a notable influence of the classification system used in the different countries. Detailed evaluation of the lymphoma distribution in the gastric wall and routine staging of the GI-tract differed between groups leaded by medical oncologists and gastroenterologists. This results in basically different patient selections and bias in treatment outcome. Similar effects were recorded for the role of gastric resection and radiotherapy. CONCLUSIONS: This study gives insight in the basis of the decisions that result in different approaches in the management of gastric MALT-NHL and in the effects for patient selection and treatment results and may help in the design of future clinical trials.

Antineoplastic Agents↗
PubMed2006

Familial aggregation in constipated subjects in a tertiary referral center.

OBJECTIVES: Clinical observation showed that there is family aggregation in constipated subjects, but formal data are lacking. This prompted us to conduct a formal family study in constipated subjects. METHODS: Constipated subjects (probands) were identified according to the Rome II and Chinese constipation questionnaire criteria, healthy subjects were chosen as controls. Living first-degree relatives (parents, siblings, and children) and spouses (as internal controls) from both groups were identified. The questionnaire on Rome II criteria was given to the relatives either through the index subjects or by mail. The questionnaire was received by mailing back or through the index subjects. Any nonresponders were chased. RESULTS: There were 132 probands with constipation and 114 controls. The Rome II questionnaire was sent to a total of 677 relatives of the probands and 591 of the controls. Relatives were comparable in mean age, sex distribution, family size, and marital status in the two groups. Constipation prevalence was 16.4% in probands' relatives versus 9.1% in controls' relatives, i.e., 13% in the relatives from both proband and controls. Among the constipated relatives, 6.3%versus 9.3% of the relatives were spouses of the probands and controls (P = 0.5). Subjects with more family members having constipation will have higher risk of constipation: OR 2.02, CI 1.14-3.65, P = 0.0177 for at least one family member; OR 3.99, CI 1.86-9.23, P = 0.0006 for at least two family members. CONCLUSIONS: Familial aggregation of constipation occurs, supporting a genetic or intrafamilial environment component.

Case-Control Studies↗
PubMed2006

Factors related to job satisfaction among South Korean dentists.

OBJECTIVES: The purposes of this study were to investigate the level and distribution of job satisfaction and to explore work environment factors associated with job satisfaction of South Korean dentists. METHODS: A stratified systematic random sample of 1029 dentists was selected from the 10 357 registered dentists in the Korean Dental Association. They were surveyed via a self-administered mail questionnaire. Job satisfaction was measured by a modified version of the Dentist Satisfaction Survey. RESULTS: The response rate was 62.2%. The mean score of overall job satisfaction among South Korean dentists was 3.2 out of 5. In terms of work environment factors, the most satisfying aspect was patient relations (3.7) and the least satisfying aspect was personal time (2.8). Multiple regression analysis identified a model including patient relations, perception of income, personal time, staff, and specialty training that accounted for 35% of variation in overall job satisfaction. The majority of the variance was explained by patient relations. CONCLUSIONS: This study suggests that patient relations, perception of income, personal time, staff, and specialty training are important work environment factors for job satisfaction among South Korean dentists. The findings of this study will be helpful to policy makers to design plans to increase the level of job satisfaction among South Korean dentists.

Adult↗
PubMed2003

Collecting behavioural data using the world wide web: considerations for researchers.

OBJECTIVE: To identify and describe advantages, challenges, and ethical considerations of web based behavioural data collection. METHODS: This discussion is based on the authors' experiences in survey development and study design, respondent recruitment, and internet research, and on the experiences of others as found in the literature. RESULTS: The advantages of using the world wide web to collect behavioural data include rapid access to numerous potential respondents and previously hidden populations, respondent openness and full participation, opportunities for student research, and reduced research costs. Challenges identified include issues related to sampling and sample representativeness, competition for the attention of respondents, and potential limitations resulting from the much cited "digital divide", literacy, and disability. Ethical considerations include anonymity and privacy, providing and substantiating informed consent, and potential risks of malfeasance. CONCLUSIONS: Computer mediated communications, including electronic mail, the world wide web, and interactive programs will play an ever increasing part in the future of behavioural science research. Justifiable concerns regarding the use of the world wide web in research exist, but as access to, and use of, the internet becomes more widely and representatively distributed globally, the world wide web will become more applicable. In fact, the world wide web may be the only research tool able to reach some previously hidden population subgroups. Furthermore, many of the criticisms of online data collection are common to other survey research methodologies.

Behavioral Research↗
PubMed2002

Epidemiologic investigations of bioterrorism-related anthrax, New Jersey, 2001.

At least four Bacillus anthracis-containing envelopes destined for New York City and Washington, D.C. were processed at the Trenton Processing and Distribution Center (PDC) on September 18 and October 9, 2001. When cutaneous anthrax was confirmed in a Trenton postal worker, the PDC was closed. Four cutaneous and two inhalational anthrax cases were identified. Five patients were hospitalized; none died. Four were PDC employees; the others handled or received mail processed there. Onset dates occurred in two clusters following envelope processing at the PDC. The attack rate among the 170 employees present when the B. anthracis-containing letters were sorted on October 9 was 1.2%. Of 137 PDC environmental samples, 57 (42%) were positive. Five (10%) of 50 local post offices each yielded one positive sample. Cutaneous or inhalational anthrax developed in four postal employees at a facility where B. anthracis-containing letters were processed. Cross-contaminated mail or equipment was the likely source of infection in two other case-patients with cutaneous anthrax.

Adult↗
PubMed1999

Screening and referral patterns for glaucoma in family practice.

The purpose of this study was to determine whether family physicians in Louisiana were (1) aware of risk factors for glaucoma; and (2) complying with USPSTF recommendations. A brief, confidential survey was mailed to family physicians. Knowledge of glaucoma and its risk factors was assessed, as were physicians' decisions to refer high-risk patients for ophthalmologic evaluation. Questions addressed awareness of treatment guidelines and screening of glaucoma, as well as select demographic data. A total of 533 surveys were distributed. Sixty-three surveys were returned by the post office, which left a usable sample size of 470. The overall response rate was 40.22% (N = 189). Seventy percent of respondents considered diabetes and hypertension risk factors. Roughly 25% routinely screened high-risk patients for glaucoma; 75% did not. Sixty percent showed correct clinical judgment in referring patients to ophthalmologists based on history and physical examination. Sixty-five percent of respondents were unaware of any guidelines or consensus statements for the treatment of glaucoma. While most family physicians can identify risk factors for glaucoma, they do not routinely screen for patients with high-risk factors.

Chi-Square Distribution↗
PubMed2002

Pancreaticoduodenectomy for islet cell tumors of the head of the pancreas: long-term survival analysis.

Pancreaticoduodenectomy (PD) has been performed infrequently for islet cell tumors of the pancreas because of the perceived perioperative morbidity and the relatively protracted natural history of those tumors. To determine whether the improved safety of PD affects long-term outcome of patients with islet cell tumors, we reviewed our experience. All consecutive patients who underwent PD or total pancreatectomy for islet cell tumors between 1980 and 1995 were analyzed. Diagnoses were based on histologic findings and endocrine (biochemical) manifestations of the tumors. Patients were followed by outpatient clinic visits and mail correspondence. Clinical and pathologic factors were analyzed for prognostic risk. Survival and recurrence curves were generated using the Kaplan-Meier method, and the log-rank test was used for comparison (p <0.05 was significant). We identified 29 patients who fulfilled the inclusion criteria with an even distribution by gender (14M:15F). Mean age of patients was 56 years (SD +/- 14 years); mean tumor size was 4.4 cm (SD +/- 2.6 cm). Most tumors were nonfunctioning (n = 20); there were 4 somatostatinomas, 3 insulinomas, and 2 gastrinomas. Operating time was 316 minutes (SD +/- 75 minutes), median transfusion requirement was 0 units (mean 1.5 units). Standard Whipple resection was performed in 20 patients; the pylorus-preserving Whipple procedure, in 7; and total pancreatectomy, in 2. Regional lymph nodes were involved by tumor in 16 patients. The complication rate was 31%, and operative mortality was 10% (n = 3). Length of hospital stay was 17 days (SD +/- 8.8 days). Overall survival was 81% and 70% at 5 and 10 years. Recurrence-free survival was 76% at 5 and 10 years. There was a trend toward greater recurrence-free survival for node-negative patients (88% vs 65% at 5 years, p = 0.13), and overall survival was greater for node-negative patients (100% vs 67% at 5 years, p = 0.04). Mean follow-up was 8.8 years. PD is an appropriate strategy for selected malignant islet cell tumors of the pancreas, which offers extended survival with a low recurrence rate and control of endocrine symptoms.

Adenoma, Islet Cell↗
PubMed2003

Solutions to the Behrens-Fisher problem.

When testing the equality of the means from two independent normally distributed populations given that the variances of the two populations are unknown but assumed equal the classical Student's two sample t-test is recommended. If the underlying population distributions are normal with unequal and unknown variances, either Welch's t-statistic or Satterthwaite's Approximate F test is suggested. However, Welch's procedure is non-robust under most non-normal distributions. There is a variable tolerance level around the strict assumptions of data independence, homogeneity of variances, identically and normal distributions. Few textbooks offer alternatives when one or more of the underlying assumptions are not defensible. We have developed an executable FORTRAN code for producing the statistics suggested by Cressie and Whitford, Yuen and Dixon, and Yuen. An executable FORTRAN is available from the author on request (e-mail only).

Animals↗
PubMed1997

A Canadian survey of issues in cancer pain management.

We report the analysis of a cancer management survey mailed to a representative group of health professionals in 1994. The goals of the study were to gather information on cancer pain treatment practices, and to obtain health professional views on obstacles to ideal pain management. The survey, designed by a working party of pharmacists, nurses and physicians, was distributed to 14,628 physicians. A total of 2,686 physicians responded to the survey, including 39% of medical or radiation oncologists, and 18.19% of physicians who listed their primary interest as Family Medicine. Reflecting the modest emphasis placed on palliative care and cancer pain management in the current Canadian milieu, 67% of physicians rated their past teaching experience as only "fair" or "poor." Lack of exposure to pain education was reflected in the response to a series of hypothetical case scenarios exploring physician choices in managing severe cancer pain. For example, in the initial management of a cancer patient with severe pain, 50% of physicians would not use a strong opioid in the absence of other contraindications to opioid use. A wide variety of analgesics and non-pharmacologic techniques is available to Canadian physicians to assist patients with pain. Few physicians identified the unavailability of analgesics or analgesic techniques as limiting factors in pain management. We conclude that greater emphasis should be placed on pain education in our training programmes. We suggest that further surveys of this type, sponsored by our provincial colleges and medical organizations, can provide feedback which will enhance the adherence by Canadian physicians to published guidelines for pain management.

Canada↗
PubMed1990

Acute respiratory illness in Adelaide children. II: The relationship of maternal stress, social supports and family functioning.

In a community-based study we investigated the relationships between maternal stress, maternal social supports, family functioning and proneness to acute respiratory illness (AR1) in childhood. 'Prone' and 'not prone' children were identified from the responses to a mail questionnaire sent to the addresses of a randomly selected group of Adelaide children who had been born in 1983. 'Prone' children (n = 255) were defined by a respiratory score (based on frequency and severity of reported symptoms in the preceding 12 months) in the top quintile of the distribution, while 'not prone' children (n = 227) were defined by a score in the bottom 20% of the range. Further information was obtained from a questionnaire administered at a home visit. Maternal stress levels were determined from a combination of major life events, minor life events and psychological distress. Maternal stress was significantly associated with respiratory proneness in a stepwise multiple logistic regression (adjusted odds ratio/high versus low = 3.8; 95% confidence interval 2.0-7.2; p = 0.000), while controlling for the effects of maternal smoking, group child care, early chest illness, number of siblings, breastfeeding, occupation, sex, age, home heating, birthweight and parental history of respiratory illness. Family dysfunction was associated with respiratory proneness in bivariate analyses but not after adjustment for the effects of other psychosocial factors in multivariate analyses. Lack of maternal social support was not associated with having a child who was prone to respiratory illness. These findings raise a number of questions about the nature and direction of the relationship between parental psychological status and child health.

Acute Disease↗
PubMed1996

Preoperative fasting time: is the traditional policy changing? Results of a national survey.

Several papers in the 1980s questioned the wisdom of withholding clear liquids for more than 3 h before elective surgery. Furthermore, recent papers have suggested relaxing the current NPO after midnight (Latin: Nulla per os; or "nothing by mouth") practice in children and adults. To see whether the policy and practice regarding NPO status before elective surgery have changed in the United States, we performed a national survey. In November 1992, 300 questionnaires were mailed to the chairpersons of 114 university anesthesiology programs and the medical directors of 186 randomly selected, free-standing ambulatory surgery centers. Seventeen simple questions were asked regarding their NPO policy and practice guidelines before elective operations. Replies were tabulated, and the data were descriptively analyzed via frequency distribution. We received 191 replies, 85 from the university programs and 106 from the free-standing units (75% and 57% response rates, respectively) from all six time zones of the United States. Fifty-seven percent of the responders stated that they had revised their NPO policy during the last 3 yr, whereas 39% reported that they had not changed their NPO policy. One hundred percent of the respondents who allowed clear liquids considered water to be acceptable for adults, whereas 94% considered water acceptable in the pediatric population. Eighty-one percent of the responders denied the use of routine prophylaxis for acid aspiration. None of the responders reported an adverse outcome which could be attributable to the recent change in the NPO guidelines. On a related question, 16% of all the respondents stated that they would cancel the operation if a patient arrived for an elective outpatient surgical procedure after consuming coffee with cream 2 h before operation. In conclusion, our survey revealed that 69% of anesthesiologists in the United States have either changed their NPO policy or are flexible in their practice in allowing clear liquids before elective operation in children and 41% have done so for adult patients. The most frequently allowed clear liquids in the adult and pediatric population were water and apple juice. None of the respondents reported any medical adverse event associated with the institution of a flexible NPO policy.

Adult↗
PubMed2002

[Allergic rhinitis epidemiology in Japan].

We epidemiologically surveyed allergic rhinitis nationwide, mailing questionnaires to 9,471 otorhinolaryngologists and their families nationwide in June 1998 responses by the end of September 1998: 42.8%, providing 17,301 subjects. Few differences were seen in the age composition between the subject population and the general Japanese population. Cedar pollinosis morbidity after adjustment for population distribution was 17.3%, higher overall on the Pacific Ocean side and in central districts of Japan compared to districts on the Sea of Japan and the Inland Sea and lower in high or low latitudes. By age, morbidity increased sharply among subjects in their teens and decreased among subjects in their 60s. Morbidity was high in districts of heavy cedar pollen dissemination. By housing, morbidity was high in the suburbs, followed by residential areas and cities. Pollinosis due to causes other than cedar pollen showed results similar to those for cedar pollinosis in morbidity by age and the relationship between the housing environment and morbidity, with morbidity after population distribution adjustment 11.7%. Morbidity of perennial allergic rhinitis after adjustment for population distribution was 19.8% was slightly higher than that of pollinosis. By age, morbidity increased sharply at 5 to 9 years of age, being highest in the young than in cedar pollinosis; no decrease in morbidity after age 60 was seen. Unlike cedar pollinosis, perennial allergic rhinitis showed no difference in morbidity by area or housing environment. The present survey using otorhinolaryngologists and their families nationwide as subjects enabled us to find areawise differences in morbidity for cedar pollinosis and perennial allergic rhinitis. Ours is useful epidemiologically in allergic rhinitis mainly for cedar pollinosis in Japan because it is superior to other questionnaires in response and because reply reliability is high.

Adolescent↗
PubMed2006

Strategy in a fishbowl: an invitation to determine the shape of IMIA in 2015.

OBJECTIVES: The International Medical Informatics Association (IMIA) today is an inclusive organization that represents the medical and health informatics world through its multiple member countries as well as affiliate, corporate and academic institutions, plus working groups and regions. The IMIA leadership deemed this is an excellent time to create a strategic alignment of IMIA's goals and in turn to create a framework of the IMIA agenda for the future. METHODS: The process began in early 2004, with a survey distributed to all IMIA members seeking members' views. The initial views were presented to the IMIA Board and General Assembly at Medinfo 2004 in San Francisco, USA. A Strategic Planning Task Force was established to take forward the development of a Strategic Plan. Through a combination of e-mail exchanges, face-to-face planning-discussion sessions in Geneva, Switzerland, and Washington DC, USA, and use of mediated conference calls, the IMIA Strategic Plan was evolved. RESULTS: The framework model (also known as the IMIA rainbow umbrella) seeks to represent, in visual and descriptive terms, the numerous possibilities for connections and integration. Knowledge is the central core of IMIA. All of our strategies, interactions and efforts, emanate from this knowledge core. Using a concentric circle model, the next circle (from the central core) represents science. This is followed by the application layer circle, then the impact layer/circle and finally the outermost circle represents the people layer. Another dimensionality of the IMIA Strategic Plan is the need to represent various key sectors. There are six sectors superimposed on the five concentric circle layers of IMIA's integration and connection to others. These sectors represent: health (our vision), research and science, behavioral responsibility, education, relationships and reach. CONCLUSION: We are still at a relatively early stage of planning. The Strategic Framework and Plan will be discussed by the IMIA Board and the IMIA General Assembly meeting (November 2006).

Data Collection↗
PubMed1994

Fecal occult blood testing: a false sense of security?

BACKGROUND: Recent screening studies with fecal occult blood testing (FOBT) report that one of three patients with colorectal cancer (CRC) can be cured of the disease; minimal attention has been given to the two of three patients who despite repeated screening go on to die of silent CRC. We report the known "miss rate" (known false negatives) of our 14-year ongoing program of FOBT that was organized in 1979 to detect early CRC. METHODS: From October 1979 through December 1993, 36,034 FOBT kits were distributed to patients who were without gastrointestinal complaints at Hines Veterans Affairs Hospital. The test was considered positive if at least one result of the six tests was positive and negative if the test result was equivocal. Patients with negative FOBT received a new test kit each year by mail. A positive test was followed by full colonoscopy or an air contrast barium enema if a full colonoscopy was not possible. RESULTS: The overall return rate was 47.8%. CRC was detected in 115 patients: 94 had a favorable and 21 had an unfavorable Duke's C or D or lymphoma prognosis. Of 21 patients 13 (62%) had initially tested FOBT negative (missed lesion). Of the 21 cases of advanced CRC 15 (71.43%) were in the descending, sigmoid, or rectosigmoid colon or rectum. CONCLUSIONS: (1) The majority (82%) of all CRC detected by FOBT screening are diagnosed at a favorable stage. (2) The majority of known advanced CRC (62%) escape early detection with FOBT. (3) Five (62.5%) of eight of the advanced CRC cases discovered on initial FOBT and 10 (76.9%) of 13 of advanced CRC cases missed on initial FOBT but detected in subsequent years were in the left colon and most likely in the range of the flexible sigmoidoscope. (4) FOBT as a sole screening test may provide a false sense of security, especially in patients with advanced left-side CRC.

Aged↗
PubMed2000

Using direct mail to recruit Hispanic adults into a dietary intervention: an experimental study.

Identifying strategies for successful recruitment of ethnic minorities into scientific studies is critical. Without effective methods, investigators may fail to recruit the desired sample size, take longer to recruit than planned, and delay progress for research in minority health. Direct mail is an appealing recruitment method because of the potential for reaching large target populations and producing a high volume of inquiries about a study with relatively little staff effort. To determine which of three direct mail strategies yielded higher recruitment, 561 Hispanic employees were randomly assigned to receive either: (a) a flyer about a worksite dietary intervention; (b) the same flyer plus a personalized hand-signed letter containing heart disease risk statistics for the general American population; or (c) the flyer plus a personalized hand-signed letter containing statistics for Hispanics. Two orthogonal chi-square comparisons were examined. The personalized letters plus flyer yielded a significantly higher response rate (7.8%) than the flyer alone (2.1%), X2(1, N = 561) = 7.5, p = .006. However, the personalized letter with Hispanic heart disease risk statistics did not yield a statistically significant higher response rate (9.1%) than the letter with the general population risk statistics (6.5%), X2(1, N = 370) = 0.9, p > .34. These findings suggest that personalized approaches can increase the effectiveness of direct mail efforts for recruiting ethnic minorities into interventions and may be particularly helpful for large-scale interventions.

Adult↗
PubMedDate not supplied

Elderly nonrespondents to a mail survey: a telephone follow-up.

The most frequently used method to request and collect health-related information has been the mail questionnaire. While self-administered surveys offer a relatively low-cost and convenient method for collecting health data, they have been unpopular among researchers because of concerns about low response rates and nonresponse bias. This study examines differences in demographic and health characteristics between mail survey respondents and nonrespondents who were subsequently interviewed by telephone. Subjects for this study had at least one health care encounter in 1990 from a Medicare-waiver program. The telephone survey was conducted approximately two months after the last wave of a three-wave mailing survey of this urban elderly population. No significant differences were found between telephone and mail respondents for demographic, socioeconomic, quality of life, or perceived oral health characteristics. However, mail respondents were more likely to be dentate and report better perceived general health than were the telephone respondents.

Aged↗