Panser L A (Section of Clinical Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA), Chute C G, Guess H A, LarsonKeller J J, Girman C J, Oesterling J E, Lieber M M and Jacobsen S J. The natural history of prostatism: The effects of non-response bias. International Journal of Epidemiology 1994; 23: 1198-1205. Background. In epidemiological studies, non-response may raise the question of generalizabllity to the target population. Most investigations have not been able to access data that could provide information about the potential impact of non-response bias. Methods. A 55% response rate was realized at baseline for a prospective cohort investigation of the natural history of benign prostatic hyperplasia in Olmsted County, Minnesota, during 1989-1991 (the Olmsted County Study of Urinary Symptoms and Health Status Among Men). This prompted a preliminary study of potential non-response bias among full participants, partial participants and complete non-responders. The medical diagnostic index maintained by the Rochester Epidemiology Project was used to ascertain the prevalence of specific conditions in the 9 years prior to study inception. Results. The age-adjusted period prevalence rate for benign prostatic hyperplasia (%) was 9.6 (95% confidence interval [Cl]: 8.1-11.0) for full participants, 8.2 (95% Cl: 5.8-10.6) for partial participants and 5.3 (95% Cl: 3.6-6.9) for complete non-responders. Other urologic diagnoses followed the same pattern. However, age-adjusted prevalence rates for general medical examination history and major non-urologic morbidities were decidedly similar across response groups. Conclusions. These data suggest response may have been driven, in part, by concerns about urologic disease However, the similarity in non-urologic diagnoses and general medical examinations provide some preliminary reassurance that the 55% response rate did not necessarily compromise generalizabllity.
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