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Is attrition bias a problem in neonatal follow-up?
E T M Hille1, A L den Ouden, M C Stuifbergen
1The Netherlands Organisation for Applied Scientific Research, Quality of Life, PO Box 2215, 2301 CE Leiden, the Netherlands. ET.Hille@pg.tno.nl
Early Human Development
|September 10, 2005
Summary
Attrition in follow-up studies of very preterm infants can underestimate adverse outcomes. Non-responders showed more disabilities and lower health utility, highlighting the need for dropout analysis in long-term assessments.
Area of Science:
- Neonatology
- Pediatric Follow-up Studies
- Biostatistics
Background:
- Long-term outcomes for very preterm infants are crucial for understanding developmental trajectories.
- Attrition in longitudinal studies can introduce bias and affect the generalizability of findings.
- Assessing the impact of participant response rates is essential for reliable follow-up research.
Purpose of the Study:
- To determine if attrition rates influence the assessed outcomes in a national follow-up study of very preterm infants.
- To compare outcomes between early, late, and non-responders at adolescent follow-up.
Main Methods:
- A national cohort of very preterm infants born in 1983 in the Netherlands was followed up at age 14 years.
- Participants were categorized into early responders, late responders, and non-responders based on their response to the follow-up invitation.
- Univariate and polytomous logistic regression analyses were used to compare neonatal data and outcomes between response groups.
Main Results:
- Non-responders and late responders had a higher prevalence of non-Dutch origin, disabilities, and school problems at age 10 years compared to early responders.
- At age 14 years, late responders exhibited a significantly lower health utility index than early responders.
- No significant differences in school outcomes were observed across response groups at age 14.
Conclusions:
- Incomplete follow-up due to attrition can lead to an underestimation of adverse outcomes in very preterm infants.
- Response rate is a significant factor affecting the assessment of late outcomes in this population.
- Future follow-up studies should incorporate dropout analyses to ensure comprehensive and comparable results.