Abrahamsen Regine, Svendsen Martin Veel, Henneberger Paul K, Gundersen Gølin Finckenhagen, Torén Kjell, Kongerud Johny, Fell Anne Kristin Møller
Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway.
BMJ Open. 2016 Jan 6;6(1):e009912. doi: 10.1136/bmjopen-2015-009912.
Declining participation in epidemiological studies has been reported in recent decades and may lead to biased prevalence estimates and selection bias. The aim of the study was to identify possible causes and effects of non-response in a population-based study of respiratory health in Norway.
The Telemark study is a longitudinal study that began with a cross-sectional survey in 2013.
In 2013, a random sample of 50,000 inhabitants aged 16-50 years, living in Telemark county, received a validated postal questionnaire. The response rate was 33%. In this study, a random sample of 700 non-responders was contacted first by telephone and then by mail.
Response rates, prevalence and OR of asthma and respiratory symptoms based on exposure to vapours, gas, dust or fumes (VGDF) and smoking. Causes of non-response.
A total of 260 non-responders (37%) participated. Non-response was associated with younger age, male sex, living in a rural area and past smoking. The prevalence was similar for responders and non-responders for physician-diagnosed asthma and several respiratory symptoms. The prevalence of chronic cough and use of asthma medication was overestimated in the Telemark study, and adjusted prevalence estimates were 17.4% and 5%, respectively. Current smoking was identified as a risk factor for respiratory symptoms among responders and non-responders, while occupational VGDF exposure was a risk factor only among responders. The Breslow-Day test detected heterogeneity between productive cough and occupational VGDF exposure among responders.
The Telemark study provided valid estimates for physician-diagnosed asthma and several respiratory symptoms, while it was necessary to adjust prevalence estimates for chronic cough and use of asthma medication. Reminder letters had little effect on risk factor associations. Selection bias should be considered in future investigations of the relationship between respiratory outcomes and exposures.
近几十年来，参与流行病学研究的人数呈下降趋势，这可能导致患病率估计有偏差以及选择偏倚。本研究的目的是在挪威一项基于人群的呼吸健康研究中确定无应答的可能原因和影响。
泰勒马克研究是一项纵向研究，始于2013年的横断面调查。
2013年，居住在泰勒马克郡的50000名16至50岁居民的随机样本收到了一份经过验证的邮政问卷。应答率为33%。在本研究中，首先通过电话联系，然后通过邮件联系了700名无应答者的随机样本。
应答率、基于接触蒸气、气体、粉尘或烟雾（VGDF）和吸烟情况的哮喘及呼吸道症状的患病率和比值比。无应答的原因。
共有260名无应答者（37%）参与。无应答与年龄较小、男性、居住在农村地区和既往吸烟有关。医生诊断的哮喘和几种呼吸道症状的应答者和无应答者的患病率相似。泰勒马克研究中慢性咳嗽和哮喘药物使用的患病率被高估，调整后的患病率估计分别为17.4%和5%。当前吸烟被确定为应答者和无应答者呼吸道症状的危险因素，而职业性VGDF暴露仅是应答者的危险因素。Breslow-Day检验检测到应答者中咳痰与职业性VGDF暴露之间存在异质性。
泰勒马克研究为医生诊断的哮喘和几种呼吸道症状提供了有效的估计，而有必要调整慢性咳嗽和哮喘药物使用的患病率估计。催复信对危险因素关联影响不大。在未来呼吸结局与暴露之间关系的调查中应考虑选择偏倚。
