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Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

Impact of targeted wording on response rates to a survey of general practitioners on referral processes for suspected head and neck cancer: an embedded randomised controlled trial

Rebecca L. Venchiarutti https://orcid.org/0000-0001-6493-7933 1 2 * , Marguerite Tracy 1 , Jonathan R. Clark 2 3 4 , Carsten E. Palme 2 3 4 , Jane M. Young 1 5
+ Author Affiliations
- Author Affiliations

1 Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia.

2 Sydney Head and Neck Cancer Institute, Department of Head and Neck Surgery, Chris O’Brien Lifehouse, Camperdown, 119-143 Missenden Road, NSW 2050, Australia.

3 Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia.

4 Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia.

5 The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Camperdown, NSW 2006, Australia.

* Correspondence to: rebecca.venchiarutti@lh.org.au

Handling Editor: Felicity Goodyear-Smith

Journal of Primary Health Care 14(3) 200-206 https://doi.org/10.1071/HC21095
Published: 10 June 2022

© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction: Low response rates to surveys can lead to non-response bias, limiting generalisability of findings. When survey topics pertain to uncommon conditions, the decision of general practitioners (GPs) to complete a questionnaire may be swayed by the perceived relevance of the questionnaire content to their practice.

Aim: To explore whether targeted wording of a questionnaire for GPs about head and neck cancer referral patterns affects response rates.

Methods: A randomised controlled trial was embedded into a larger survey on referral practices for head and neck cancer among GPs in New South Wales, Australia. GPs were randomly allocated to receive versions of the study material with explanatory text written using either a ‘symptom-frame’ or a ‘cancer-frame’; however, the questions and responses were the same in both groups.

Results: The overall response rate was 10.9% (196/1803). The response rate to the ‘cancer-frame’ version was 10.6% and 11.1% for the ‘symptom-frame’ version. After adjusting for practice location and GP gender, the difference in response rate based on wording was not significant (difference 0.5% [95%CI: −2.4, 3.4%]). A sub-analysis showed that GPs practicing in regional New South Wales were more likely to respond to the survey compared to those practicing in metropolitan New South Wales, independent of the intervention group or participant sex (AOR 1.61 [95%CI: 1.12, 2.31]; P = 0.01).

Discussion: The wording ‘frame’ of the survey did not appear to impact response rates in a survey of referral practices for suspected head and neck cancer; however, the significantly higher response rate from regional GPs warrants further investigation as to whether the content was considered more salient to their practice.

Keywords: diagnosis delay, general practice, geography, head and neck cancer, health-care access, primary care, randomised controlled trial, variation.


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