Nicks Bret A, Shah Manish N, Adler David H, Bastani Aveh, Baugh Christopher W, Caterino Jeffrey M, Clark Carol L, Diercks Deborah B, Hollander Judd E, Malveau Susan E, Nishijima Daniel K, Stiffler Kirk A, Storrow Alan B, Wilber Scott T, Yagapen Annick N, Sun Benjamin C
Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI.
Acad Emerg Med. 2017 Apr;24(4):458-466. doi: 10.1111/acem.13135. Epub 2017 Mar 17.
Loss to follow-up of enrolled patients (a.k.a. attrition) is a major threat to study validity and power. Minimizing attrition can be challenging even under ideal research conditions, including the presence of adequate funding, experienced study personnel, and a refined research infrastructure. Emergency care research is shifting toward enrollment through multisite networks, but there have been limited descriptions of approaches to minimize attrition for these multicenter emergency care studies. This concept paper describes a stepwise approach to minimize attrition, using a case example of a multisite emergency department prospective cohort of over 3,000 patients that has achieved a 30-day direct phone follow-up attrition rate of <3%. The seven areas of approach to minimize attrition in this study focused on patient selection, baseline contact data collection, patient incentives, patient tracking, central phone banks, local enrollment site assistance, and continuous performance monitoring. Appropriate study design, including consideration of these methods to reduce attrition, will be time well spent and may improve study validity.
已登记患者的失访（又称损耗）是对研究有效性和效能的重大威胁。即使在理想的研究条件下，包括有充足的资金、经验丰富的研究人员和完善的研究基础设施，将损耗降至最低也可能具有挑战性。急诊护理研究正转向通过多站点网络进行招募，但对于这些多中心急诊护理研究中减少损耗的方法，描述有限。本概念文件描述了一种逐步减少损耗的方法，并以一个多站点急诊科超过3000名患者的前瞻性队列研究为例，该研究实现了30天直接电话随访损耗率低于3%。本研究中减少损耗的七个方法领域集中在患者选择、基线联系数据收集、患者激励、患者追踪、中央电话银行、当地招募站点协助以及持续绩效监测。适当的研究设计，包括考虑这些减少损耗的方法，将是物有所值的，并且可能提高研究的有效性。
