Robinson Karen A, Dennison Cheryl R, Wayman Dawn M, Pronovost Peter J, Needham Dale M
Division of Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
J Clin Epidemiol. 2007 Aug;60(8):757-65. doi: 10.1016/j.jclinepi.2006.11.023. Epub 2007 May 10.
Loss to follow-up threatens internal and external validity yet little research has examined ways to limit participant attrition. We conducted a systematic review of studies with a primary focus on strategies to retain participants in health care research.
We completed searches of PubMed, CINAHL, CENTRAL, Cochrane Methodology Register, and EMBASE (August 2005). We also examined reference lists of eligible articles and relevant reviews. A data-driven thematic analysis of the retention strategies identified common themes.
We retrieved 3,068 citations, 21 studies were eligible for inclusion. We abstracted 368 strategies and from these identified 12 themes. The studies reported a median of 17 strategies across a median of six themes. The most commonly reported strategies were systematic methods of participant contact and scheduling. Studies with retention rates lower than the mean rate (86%) reported fewer strategies. There was no difference in the number of different themes used.
Available evidence suggests that investigators should consider using a number of retention strategies across several themes to maximize the retention of participants. Further research, including explicit evaluation of the effectiveness of different strategies, is needed.
失访会威胁到研究的内部和外部效度,但很少有研究探讨限制参与者流失的方法。我们对主要关注在医疗保健研究中留住参与者策略的研究进行了系统综述。
我们于2005年8月完成了对PubMed、CINAHL、CENTRAL、Cochrane方法学注册库和EMBASE的检索。我们还查阅了符合条件文章及相关综述的参考文献列表。对留存策略进行数据驱动的主题分析,确定了共同主题。
我们检索到3068条引文,21项研究符合纳入条件。我们提取了368种策略,并从中确定了12个主题。这些研究报告的策略中位数为17种,涉及的主题中位数为6个。最常报告的策略是与参与者联系和安排时间的系统方法。留存率低于平均水平(86%)的研究报告的策略较少。所使用的不同主题数量没有差异。
现有证据表明,研究人员应考虑在多个主题中使用多种留存策略,以最大限度地留住参与者。需要进一步开展研究,包括对不同策略有效性的明确评估。