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Asthmatics and ex-smokers respond early, heavy smokers respond late to mailed surveys in Italy

Verlato, Giuseppe and Melotti, Roberto and Olivieri, Mario and Corsico, Angelo Guido and Bugiani, Massimiliano and Accordini, Simone and Villani, Simona and Migliore, Enrica and Marinoni, Alessandra and Pirina, Pietro and Carrozzi, Laura and Bortolami, Oscar and Rava, Marta and De Marco, Roberto (2010) Asthmatics and ex-smokers respond early, heavy smokers respond late to mailed surveys in Italy. Respiratory Medicine, Vol. 104 (2), p. 172-179. eISSN 1532-3064. Article.

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DOI: 10.1016/j.rmed.2009.09.022

Abstract

Rationale and objectives
Response to mailed epidemiological surveys has decreased in recent decades. Since subjects with respiratory symptoms are usually early responders to surveys performed in Southern Europe, this trend could bias prevalence estimates. The present study aimed at evaluating the impact of non-response bias on prevalence estimates of respiratory symptoms and smoking habits.
Methods
In 9 centres, participating in the Italian Study on Asthma in Young Adults (ISAYA), random samples of people aged 20–45 years were administered a mailed questionnaire between 1998 and 2000. Non-responders were contacted again first by mail and then by phone. Cumulative response percentage was 30.5%, 52.4% and 72.7% (18,873/25,969), respectively, after the 1st, 2nd and 3rd contact.
Results
The prevalence of self-reported current asthma, asthma-like symptoms, and chronic cough/phlegm was more than halved from the first contact (5.6%, 17.8%, 14.6% respectively) to the third contact (2.7%, 6.4%, 6.9%). This pattern was less pronounced when considering allergic rhinitis and past asthma, whose prevalence decreased, respectively, from 21.5% to 15.6% and from 3.5% to 2.6%. At the same time the proportion of current smokers increased from 29.2% to 38%, while the proportion of ex-smokers decreased from 16.5% to 10.1%. In a multinomial logistic model current asthma, asthma-like symptoms, chronic cough/phlegm and smoking habits, and to a lower extent past asthma and allergic rhinitis, were significant predictors of late response.
Conclusions
In Italy when response percentage is low, the prevalence of current asthma, chronic cough/phlegm and ex-smokers is overestimated, while the proportion of current smokers is underestimated.

Item Type:Article
ID Code:5714
Status:Published
Refereed:Yes
Uncontrolled Keywords:Mail survey, response bias, respiratory symptoms, asthma, allergic rhinitis, smoking habits
Subjects:Area 06 - Scienze mediche > MED/10 Malattie dell'apparato respiratorio
Divisions:001 Università di Sassari > 03 Istituti > Tisiologia e malattie dell'apparato respiratorio
Publisher:Elsevier
eISSN:1532-3064
Copyright Holders:© 2009 Elsevier
Additional Information:Tra gli autori figura: ISAYA study group
Deposited On:04 Mar 2011 13:39

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