HHS Public Access Author manuscript Author Manuscript
J Clin Epidemiol. Author manuscript; available in PMC 2017 June 01. Published in final edited form as: J Clin Epidemiol. 2016 December ; 80: 134–135. doi:10.1016/j.jclinepi.2016.07.015.
Telephone vs. Web-based prescreening predicts early but not overall physician response to a mailed survey Hillary Bonuedie1, Leonard Davis Institute of Health Economics SUMR Program, 3641 Locust Walk # 210, Philadelphia, PA 19104, USA
Author Manuscript
Esther Kim1, Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104, USA Judith Long, and Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, 12-01 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Ave, Philadelphia, PA 19104, USA Kira Ryskina* Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, 12-30 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
Author Manuscript
1. Low-budget approaches to increase physician response to surveys
Author Manuscript
Low response rates remain a challenge to survey studies of clinicians [1]. Low-budget approaches to increasing response include shorter survey length [2,3], and personalization of survey materials [4], with mixed results. Advance contact of physicians, or prescreening, is another strategy. Although Web-based prescreening is less expensive and bothersome to physicians and office staff than telephone contact, it is limited to the information available online and precludes advance notice of mailings. To evaluate these approaches, we modeled the association between each strategy and physician response: (1) Web vs. telephone prescreening, (2) short vs. long questionnaire, and (3) personalization (handwritten vs. typed materials), from a 45-item survey about physician views of overtreatment guidelines mailed by first-class mail with a $2 bill in July 2014, followed by two remailings 6 weeks apart.
2. Web-based prescreening algorithm Of the 2,170 internists randomly selected from the AMA masterfile, 1,128 (52.0%) received phone calls to confirm address, specialty, and active clinical practice and 1,042 (48.0%) were prescreened via the Web. First, specialty was confirmed using healthgrades.com. Next,
*
Corresponding author. Tel.: +1-215-898-3935; fax: +1-215-573-2742. [email protected] (K. Ryskina). 1Both authors contributed equally to the study.
Conflict of interest: None.
Bonuedie et al.
Page 2
Author Manuscript
office address was mapped using maps.google.com to exclude hospitalists (practice address at a hospital) and physicians who relocated (whose database and healthgrades.com addresses were more than half-hour drive apart). Nonrespondents to the initial mailing received a single follow-up call to confirm eligibility. Telephone prescreening confirmed the eligibility of 329/1,128 (29.2%) and Web-based of 573/1,042 (55.0%) physicians. Web-based prescreening took half the time spent on telephone prescreening. There was no difference in response rates between telephone vs. Web-based approaches (52.6% vs. 49.3%, P = 0.34). Physicians pre-screened by telephone were more likely to respond early (odds ratio [OR] 2.74; 95% confidence interval [CI] 1.35– 5.57; P < 0.01); however, there was no difference in the odds of overall response (OR 1.15; 95% CI 0.80–1.66; P = 0.46).
Author Manuscript
3. Varying survey length and personalization Personalization of envelopes meant that the recipient address was handwritten. Personalization of cover letters meant that the cover letter and the salutation were handwritten. Two alternative survey lengths were tested (varying the amount of white space): five vs. four pages. There was no difference in response rates between handwritten vs. typed materials (51.0% vs. 46.9% for envelopes, P = 0.34; 55.6% vs. 51.6% for cover letters, P = 0.54); or between shorter vs. longer surveys (54.1% vs. 48.2%, P = 0.36) or in the odds of response.
4. Web-based prescreening predicts early but not overall physician response Author Manuscript
The Web-based prescreening resulted in comparable odds of obtaining a response but was half as labor intensive as the telephone approach. Physicians who were pre-screened via telephone were more likely to respond early, which may reflect “priming” through direct contact with office staff or an indication of overall ease of access to the physician. Consistent with prior reports [5], less than a third of potential respondents were found eligible after telephone prescreening. Although Web-based prescreening is not a perfect substitute for telephone prescreening, it can be used in place of telephone prescreening as long as researchers follow-up with nonrespondents.
Acknowledgments Funding: K.R. is supported by the Ruth L. Kirschstein National Research Service Award (T32-HP10026) and is also the recipient of NIA Career Development Award (K08AG052572).
Author Manuscript
References 1. Cho YI, Johnson TP, VanGeest JB. Enhancing surveys of health care professionals: a meta-analysis of techniques to improve response. Eval Health Prof. 2013; 36(3):382–407. [PubMed: 23975761] 2. Jepson C, Asch DA, Hershey JC, Ubel PA. In a mailed physician survey, questionnaire length had a threshold effect on response rate. J Clin Epidemiol. 2005; 58:103–5. [PubMed: 15649678]
J Clin Epidemiol. Author manuscript; available in PMC 2017 June 01.
Bonuedie et al.
Page 3
Author Manuscript
3. Bolt EE, van der Heide A, Onwuteaka-Philipsen BD. Reducing questionnaire length did not improve physician response rate: a randomized trial. J Clin Epidemiol. 2014; 67:477–81. [PubMed: 24290148] 4. Levy RM, Shapiro M, Halpern SD, Ming ME. Effect of personalization and candy incentive on response rates for a mailed survey of dermatologists. J Invest Dermatol. 2012; 132:724–6. [PubMed: 22158555] 5. DesRoches CM, Barrett KA, Harvey BE, Kogan R, Reschovsky JD, Landon BE, et al. The results are only as good as the sample: assessing three national physician sampling frames. J Gen Intern Med. 2015; 30:S595–601. [PubMed: 26105676]
Author Manuscript Author Manuscript Author Manuscript J Clin Epidemiol. Author manuscript; available in PMC 2017 June 01.
J Clin Epidemiol. Author manuscript; available in PMC 2017 June 01. Published in final edited form as: J Clin Epidemiol. 2016 December ; 80: 134–135. doi:10.1016/j.jclinepi.2016.07.015.
Telephone vs. Web-based prescreening predicts early but not overall physician response to a mailed survey Hillary Bonuedie1, Leonard Davis Institute of Health Economics SUMR Program, 3641 Locust Walk # 210, Philadelphia, PA 19104, USA
Author Manuscript
Esther Kim1, Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, Philadelphia, PA 19104, USA Judith Long, and Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, 12-01 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Ave, Philadelphia, PA 19104, USA Kira Ryskina* Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, 12-30 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA
Author Manuscript
1. Low-budget approaches to increase physician response to surveys
Author Manuscript
Low response rates remain a challenge to survey studies of clinicians [1]. Low-budget approaches to increasing response include shorter survey length [2,3], and personalization of survey materials [4], with mixed results. Advance contact of physicians, or prescreening, is another strategy. Although Web-based prescreening is less expensive and bothersome to physicians and office staff than telephone contact, it is limited to the information available online and precludes advance notice of mailings. To evaluate these approaches, we modeled the association between each strategy and physician response: (1) Web vs. telephone prescreening, (2) short vs. long questionnaire, and (3) personalization (handwritten vs. typed materials), from a 45-item survey about physician views of overtreatment guidelines mailed by first-class mail with a $2 bill in July 2014, followed by two remailings 6 weeks apart.
2. Web-based prescreening algorithm Of the 2,170 internists randomly selected from the AMA masterfile, 1,128 (52.0%) received phone calls to confirm address, specialty, and active clinical practice and 1,042 (48.0%) were prescreened via the Web. First, specialty was confirmed using healthgrades.com. Next,
*
Corresponding author. Tel.: +1-215-898-3935; fax: +1-215-573-2742. [email protected] (K. Ryskina). 1Both authors contributed equally to the study.
Conflict of interest: None.
Bonuedie et al.
Page 2
Author Manuscript
office address was mapped using maps.google.com to exclude hospitalists (practice address at a hospital) and physicians who relocated (whose database and healthgrades.com addresses were more than half-hour drive apart). Nonrespondents to the initial mailing received a single follow-up call to confirm eligibility. Telephone prescreening confirmed the eligibility of 329/1,128 (29.2%) and Web-based of 573/1,042 (55.0%) physicians. Web-based prescreening took half the time spent on telephone prescreening. There was no difference in response rates between telephone vs. Web-based approaches (52.6% vs. 49.3%, P = 0.34). Physicians pre-screened by telephone were more likely to respond early (odds ratio [OR] 2.74; 95% confidence interval [CI] 1.35– 5.57; P < 0.01); however, there was no difference in the odds of overall response (OR 1.15; 95% CI 0.80–1.66; P = 0.46).
Author Manuscript
3. Varying survey length and personalization Personalization of envelopes meant that the recipient address was handwritten. Personalization of cover letters meant that the cover letter and the salutation were handwritten. Two alternative survey lengths were tested (varying the amount of white space): five vs. four pages. There was no difference in response rates between handwritten vs. typed materials (51.0% vs. 46.9% for envelopes, P = 0.34; 55.6% vs. 51.6% for cover letters, P = 0.54); or between shorter vs. longer surveys (54.1% vs. 48.2%, P = 0.36) or in the odds of response.
4. Web-based prescreening predicts early but not overall physician response Author Manuscript
The Web-based prescreening resulted in comparable odds of obtaining a response but was half as labor intensive as the telephone approach. Physicians who were pre-screened via telephone were more likely to respond early, which may reflect “priming” through direct contact with office staff or an indication of overall ease of access to the physician. Consistent with prior reports [5], less than a third of potential respondents were found eligible after telephone prescreening. Although Web-based prescreening is not a perfect substitute for telephone prescreening, it can be used in place of telephone prescreening as long as researchers follow-up with nonrespondents.
Acknowledgments Funding: K.R. is supported by the Ruth L. Kirschstein National Research Service Award (T32-HP10026) and is also the recipient of NIA Career Development Award (K08AG052572).
Author Manuscript
References 1. Cho YI, Johnson TP, VanGeest JB. Enhancing surveys of health care professionals: a meta-analysis of techniques to improve response. Eval Health Prof. 2013; 36(3):382–407. [PubMed: 23975761] 2. Jepson C, Asch DA, Hershey JC, Ubel PA. In a mailed physician survey, questionnaire length had a threshold effect on response rate. J Clin Epidemiol. 2005; 58:103–5. [PubMed: 15649678]
J Clin Epidemiol. Author manuscript; available in PMC 2017 June 01.
Bonuedie et al.
Page 3
Author Manuscript
3. Bolt EE, van der Heide A, Onwuteaka-Philipsen BD. Reducing questionnaire length did not improve physician response rate: a randomized trial. J Clin Epidemiol. 2014; 67:477–81. [PubMed: 24290148] 4. Levy RM, Shapiro M, Halpern SD, Ming ME. Effect of personalization and candy incentive on response rates for a mailed survey of dermatologists. J Invest Dermatol. 2012; 132:724–6. [PubMed: 22158555] 5. DesRoches CM, Barrett KA, Harvey BE, Kogan R, Reschovsky JD, Landon BE, et al. The results are only as good as the sample: assessing three national physician sampling frames. J Gen Intern Med. 2015; 30:S595–601. [PubMed: 26105676]
Author Manuscript Author Manuscript Author Manuscript J Clin Epidemiol. Author manuscript; available in PMC 2017 June 01.
