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Updated: Feb 24, 2026

E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
A randomized trial found online questionnaires supplemented by postal reminders generated a cost-effective and
Amanda Loban1, Laura Mandefield1, Daniel Hind1
1Clinical Trials Research Unit, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK.
Objectives:
The objective of this study was to compare the response rates, data completeness, and representativeness of survey data produced by online and postal surveys.
Study Design And Setting:
A randomized trial nested within a cohort study in Yorkshire, United Kingdom. Participants were randomized to receive either an electronic (online) survey questionnaire with paper reminder (N = 2,982) or paper questionnaire with electronic reminder (N = 2,855).
Results:
Response rates were similar for electronic contact and postal contacts (50.9% vs. 49.7%, difference = 1.2%, 95% confidence interval: -1.3% to 3.8%). The characteristics of those responding to the two groups were similar. Participants nevertheless demonstrated an overwhelming preference for postal questionnaires, with the majority responding by post in both groups.
Conclusion:
Online survey questionnaire systems need to be supplemented with a postal reminder to achieve acceptable uptake, but doing so provides a similar response rate and case mix when compared to postal questionnaires alone. For large surveys, online survey systems may be cost saving.
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