Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States.
The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH, United States.
J Med Internet Res. 2023 Nov 1;25:e48236. doi: 10.2196/48236.
Surveys of hospitalized patients are important for research and learning about unobservable medical issues (eg, mental health, quality of life, and symptoms), but there has been little work examining survey data quality in this population whose capacity to respond to survey items may differ from the general population.
The aim of this study is to determine what factors drive response rates, survey drop-offs, and missing data in surveys of hospitalized patients.
Cross-sectional surveys were distributed on an inpatient tablet to patients in a large, midwestern US hospital. Three versions were tested: 1 with 174 items and 2 with 111 items; one 111-item version had missing item reminders that prompted participants when they did not answer items. Response rate, drop-off rate (abandoning survey before completion), and item missingness (skipping items) were examined to investigate data quality. Chi-square tests, Kaplan-Meyer survival curves, and distribution charts were used to compare data quality among survey versions. Response duration was computed for each version.
Overall, 2981 patients responded. Response rate did not differ between the 174- and 111-item versions (81.7% vs 83%, P=.53). Drop-off was significantly reduced when the survey was shortened (65.7% vs 20.2% of participants dropped off, P<.001). Approximately one-quarter of participants dropped off by item 120, with over half dropping off by item 158. The percentage of participants with missing data decreased substantially when missing item reminders were added (77.2% vs 31.7% of participants, P<.001). The mean percentage of items with missing data was reduced in the shorter survey (40.7% vs 20.3% of items missing); with missing item reminders, the percentage of items with missing data was further reduced (20.3% vs 11.7% of items missing). Across versions, for the median participant, each item added 24.6 seconds to a survey's duration.
Hospitalized patients may have a higher tolerance for longer surveys than the general population, but surveys given to hospitalized patients should have a maximum of 120 items to ensure high rates of completion. Missing item prompts should be used to reduce missing data. Future research should examine generalizability to nonhospitalized individuals.
对住院患者进行调查对于研究和了解不可观察的医疗问题（例如，心理健康、生活质量和症状）很重要，但对于那些回答调查项目的能力可能与一般人群不同的患者群体，很少有研究调查调查数据的质量。
本研究旨在确定哪些因素会影响住院患者调查的应答率、调查中途退出率和缺失数据。
采用横断面调查，在一家位于美国中西部的大型医院的住院患者平板电脑上进行。共测试了 3 个版本：1 个包含 174 个项目，2 个包含 111 个项目；其中一个 111 项版本有缺失项目提示，当参与者未回答项目时会提示他们。调查的应答率、中途退出率（在完成前放弃调查）和项目缺失率（跳过项目）用于调查数据质量。使用卡方检验、卡普兰-迈耶生存曲线和分布图表比较了不同版本的调查数据质量。计算了每个版本的响应持续时间。
共有 2981 名患者做出了回应。174 项和 111 项版本的应答率没有差异（81.7%与 83%，P=.53）。当调查缩短时，中途退出率显著降低（65.7%与 20.2%的参与者中途退出，P<.001）。大约四分之一的参与者在第 120 项时中途退出，超过一半的参与者在第 158 项时中途退出。当添加缺失项目提示时，缺失数据的参与者比例大幅下降（77.2%与 31.7%的参与者缺失数据，P<.001）。在较短的调查中，缺失数据的平均项目百分比显著降低（40.7%与 20.3%的项目缺失数据）；添加缺失项目提示后，缺失数据的项目百分比进一步降低（20.3%与 11.7%的项目缺失数据）。在所有版本中，对于中位数参与者，每个项目将调查的持续时间增加 24.6 秒。
住院患者对较长的调查可能有更高的容忍度，而不是一般人群，但给住院患者的调查应该最多有 120 个项目，以确保完成率高。应使用缺失项目提示来减少缺失数据。未来的研究应检验对非住院个体的推广性。
