Shahar E, Folsom A R, Jackson R
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015, USA.
Ann Epidemiol. 1996 Nov;6(6):498-506. doi: 10.1016/s1047-2797(96)00104-4.
Characterization of nonrespondents, with the aim of detecting nonresponse bias, is a crucial component of prospective studies. This study was undertaken to investigate the demographic and health characteristics of nonrespondents to a population-based cohort study of cardiovascular disease, to determine whether early-stage nonrespondents differ from late-stage nonrespondents, and to estimate the bias in prevalence estimates for the source population. Sixty-seven percent of eligible subjects completed all phases of the cohort recruitment. Compared to respondents, nonrespondents were less likely to be married, less likely to be employed, and less likely to be well educated. Nonrespondents tended to describe their general health in less favorable terms and were more likely to be smokers. Their reported disease profile, however, was not dissimilar to that of respondents. For several demographic and health characteristics, including marital status, education, and smoking, early-stage nonrespondents differed from respondents more than did late-stage nonrespondents. For example, 42% of early nonrespondents were smokers compared to 37% of late nonrespondents and 22% of respondents. Overall, the bias in prevalence estimates related to nonresponse was small (< 5%) for most of the measured characteristics. Although nonresponse to health surveys is associated with typical attributes, early nonrespondents differ from respondents more than do late-stage nonrespondents. With few exceptions, however, a 33% nonresponse rate did not appear to introduce substantial bias into prevalence estimates for the source community.
为检测无应答偏倚而对无应答者进行特征描述，是前瞻性研究的关键组成部分。本研究旨在调查一项基于人群的心血管疾病队列研究中无应答者的人口统计学和健康特征，确定早期无应答者与晚期无应答者是否存在差异，并估计源人群患病率估计中的偏倚。67%符合条件的受试者完成了队列招募的所有阶段。与应答者相比，无应答者结婚的可能性较小、就业的可能性较小且受教育程度较低。无应答者倾向于用不太乐观的措辞描述自己的总体健康状况，且更有可能是吸烟者。然而，他们报告的疾病概况与应答者并无不同。在包括婚姻状况、教育程度和吸烟等多项人口统计学和健康特征方面，早期无应答者与应答者的差异大于晚期无应答者与应答者的差异。例如，42%的早期无应答者是吸烟者，而晚期无应答者为37%，应答者为22%。总体而言，对于大多数测量特征，与无应答相关的患病率估计偏倚较小（<5%）。尽管健康调查中的无应答与典型特征相关，但早期无应答者与应答者的差异大于晚期无应答者与应答者的差异。然而，除少数例外情况外，33%的无应答率似乎并未给源社区的患病率估计带来实质性偏倚。
