Remember Me
Or use your Academic/Social account:


Or use your Academic/Social account:


You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.


Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message


Verify Password:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Gates Simon; Jørstad-Stein Ellen C; Hutton Jane L; Nakash Rachel A; Lamb Sarah E (2006)
Publisher: BioMed Central
Journal: BMC Medical Research Methodology
Languages: English
Types: Article
Subjects: Epidemiology, Research Article, R5-920, Medicine (General), R1



Postal self-completion questionnaires offer one of the least expensive modes of collecting patient based outcomes in health care research. The purpose of this review is to assess the efficacy of methods of increasing response to postal questionnaires in health care studies on patient populations.


The following databases were searched: Medline, Embase, CENTRAL, CDSR, PsycINFO, NRR and ZETOC. Reference lists of relevant reviews and relevant journals were hand searched. Inclusion criteria were randomised trials of strategies to improve questionnaire response in health care research on patient populations. Response rate was defined as the percentage of questionnaires returned after all follow-up efforts. Study quality was assessed by two independent reviewers. The Mantel-Haenszel method was used to calculate the pooled odds ratios.


Thirteen studies reporting fifteen trials were included. Implementation of reminder letters and telephone contact had the most significant effect on response rates (odds ratio 3.7, 95% confidence interval 2.30 to 5.97 p = <0.00001). Shorter questionnaires also improved response rates to a lesser degree (odds ratio 1.4, 95% confidence interval 1.19 to 1.54). No evidence was found that incentives, re-ordering of questions or including an information brochure with the questionnaire confer any additional advantage.


Implementing repeat mailing strategies and/or telephone reminders may improve response to postal questionnaires in health care research. Making the questionnaire shorter may also improve response rates. There is a lack of evidence to suggest that incentives are useful. In the context of health care research all strategies to improve response to postal questionnaires require further evaluation.

  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Edwards P, Roberts I, Clarke M, DiGuiseppi C, Pratap S, Wentz R, Kwan I: Increasing response rates to postal questionnaires: systematic review. BMJ 2002, 324(7347):1183-1190.
    • 2. Yammarino FJ, Skinner SJ, Childers TL: Understanding Mail Survey Response Behaviour - A Meta-Analysis. Public Opinion Quarterly 1991, 55(4):613-639.
    • 3. Fox RJ, Crask MR, Kim J: Mail Survey Response Rate: A MetaAnalysis of Selected Techniques for Inducing Response. Public Opinion Quarterly 1988, 52(4):467-491.
    • 4. Harvey L: Factors Affecting Response Rates to Mailed Questionnaires: A Comprehensive Literature review. Journal of the Market Research Society 1987, 29:341-353.
    • 5. Kanuk L: Mail Surveys and Response Rates: A Literature Review. Journal of Marketing Research 1975, 12:440-453.
    • 6. Smeeth L, Fletcher AE: Improving the response rates to questionnaires. BMJ 2002, 324(7347):1168-1169.
    • 7. McColl E, Jacoby A, Thomas L, Soutter J, Bamford C, Steen N, Thomas R, Harvey E, Garratt A, Bond J: Design and use of questionnaires: a review of best practice applicable to surveys of health service staff and patients. Health Technol Assess 2001, 5(31):1-256.
    • 8. O'Cathain A: Further Analyses Would Make the Review More Helpful - Rapid Response to Edwards et al Increasing Response Rates to Postal Questionnaires: Systematic Review. BMJ 2002, 324:.
    • 9. Yusuf S, Collins R, Peto R: Why do we need some large, simple randomised trials? Stat Med 1984, 3(4):409-422.
    • 10. Maxim PS: Quantitative Research Methods in the Social Sciences. New York, Oxford , Oxford University Press; 1999.
    • 11. Schulz KF, Grimes DA: Sample size slippages in randomised trials: exclusions and the lost and wayward. Lancet 2002, 359(9308):781-785.
    • 12. Armstrong BK, White E, Saracci R: Principles of exposure measurement in epidemiology. In Monographs in Epidemiology and Biostatistics Volume 21. New York , Oxford University Press; 1995:294-321.
    • 13. BMJ Cite Track Alert [http://bmj.com/cgi/alerts/ctmain]
    • 14. BioMail Medline Search version 0.72pre [http://biomail.source forge.net/biomail].
    • 15. McCaul LA, Cooper PG: Techniques to increase the response rate in follow-up studies: results of a pilot test. Int J Rehabil Res 1979, 2(4):465-470.
    • 16. The Chambers Dictionary. Edited by: Anderson S, Carey L, Cullen K, Flackett S, Grandison A. Chambers Harrap Publishers Ltd; 1998.
    • 17. Clarke M, Oxman AD: Assessment of Study Quality. Cochrane Reviewers' Handbook In: The Cochrane Library 2003, 4.2.0(2):.
    • 18. Verhagen AP, de Vet HC, de Bie RA, Kessels AG, Boers M, Bouter LM, Knipschild PG: The Delphi list: a criteria list for quality assessment of randomised clinical trials for conducting systematic reviews developed by Delphi consensus. J Clin Epidemiol 1998, 51(12):1235-1241.
    • 19. Higgins JP, Thompson SG: Quantifying heterogeneity in a metaanalysis. Stat Med 2002, 21(11):1539-1558.
    • 20. Iglesias C, Torgerson D: Does length of questionnaire matter? A randomised trial of response rates to a mailed questionnaire. J Health Serv Res Policy 2000, 5(4):219-221.
    • 21. Dorman PJ, Slattery J, Farrell B, Dennis MS, Sandercock PA: A randomised comparison of the EuroQol and Short Form-36 after stroke. United Kingdom collaborators in the International Stroke Trial. BMJ 1997, 315(7106):461.
    • 22. Dunn KM, Jordan K, Croft PR: Does questionnaire structure influence response in postal surveys? J Clin Epidemiol 2003, 56(1):10-16.
    • 23. Jenkinson C, Coulter A, Reeves R, Bruster S, Richards N: Properties of the Picker Patient Experience questionnaire in a randomised controlled trial of long versus short form survey instruments. J Public Health Med 2003, 25(3):197-201.
    • 24. Jones R, Zhou M, Yates WR: Improving return rates for healthcare outcome. Psychol Rep 2000, 87(2):639-642.
    • 25. Ward J, Boyle C, Long D, Ovadia C: Patient surveys in general practice: a randomised trial of an instant lottery ticket to increase return rate. Aust Fam Physician 1996, Suppl 1:S19-20.
    • 26. Leigh Brown AP, Lawrie HE, Kennedy AD, Webb JA, Torgerson DJ, Grant AM: Cost effectiveness of a prize draw on response to a postal questionnaire: results of a randomised trial among orthopaedic outpatients in Edinburgh. J Epidemiol Community Health 1997, 51(4):463-464.
    • 27. Evans BR, Peterson BL, Demark-Wahnefried W: No Difference in Response Rate to a Mailed Survey among Prostate Cancer Survivors Using Conditional versus Unconditional Incentives. Cancer Epidemiol Biomarkers Prev 2004, 13(2):277-278.
    • 28. McColl E, Eccles MP, Rousseau NS, Steen IN, Parkin DW, Grimshaw JM: From the generic to the condition-specific?: Instrument order effects in Quality of Life Assessment. Med Care 2003, 41(7):777-790.
    • 29. Tai SS, Nazareth I, Haines A, Jowett C: A randomized trial of the impact of telephone and recorded delivery reminders on the response rate to research questionnaires. J Public Health Med 1997, 19(2):219-221.
    • 30. Salim Silva M, Smith WT, Bammer G: Telephone reminders are a cost effective way to improve responses in postal health surveys. J Epidemiol Community Health 2002, 56(2):115-118.
    • 31. Sutherland HJ, Beaton M, Mazer R, Kriukov V, Boyd NF: A randomized trial of the total design method for the postal followup of women in a cancer prevention trial. Eur J Cancer Prev 1996, 5(3):165-168.
    • 32. Parkes R, Kreiger N, James B, Johnson KC: Effects on subject response of information brochures and small cash incentives in a mail-based case-control study. Ann Epidemiol 2000, 10(2):117-124.
    • 33. Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB: Evidence-based medicine: how to practice and teach EBM. Edinburgh , Churchill Livingstone; 2000:108-109.
    • 34. Meinert CL, Tonascia S: Clinical Trials: Design, Conduct and Analysis. New York , Oxford University Press; 1986:160-161.
    • 35. Ludemann R, Watson DI, Jamieson GG: Influence of follow-up methodology and completeness on apparent clinical outcome of fundoplication. Am J Surg 2003, 186(2):143-147.
    • 36. Heberlein TA, Baumgartner R: Factors Affecting Response Rates to Mailed Questionnaires: A Quantitative Analysis of the Published Literature. American Sociological Review 1978, 43(4):447-462.
    • 37. Kerlinger RN: Foundations of behavioral research. Second edition. New York , Holt, Rinehart; 1975.
    • 38. Edwards P, Roberts I, Sandercock P, Frost C: Follow-up by mail in clinical trials: does questionnaire length matter? Control Clin Trials 2004, 25(1):31-52.
    • 39. Bowling A: Research Methods in Health. Buckingham, Philadelphia , Open University Press; 1997:234-235.
    • 40. Harrison RA, Holt D, Elton PJ: Do postage-stamps increase response rates to postal surveys? A randomized controlled trial. Int J Epidemiol 2002, 31(4):872-874.
    • 41. Kalantar JS, Talley NJ: The effects of lottery incentive and length of questionnaire on health survey response rates: a randomized study. J Clin Epidemiol 1999, 52(11):1117-1122.
  • No related research data.
  • No similar publications.