Methods for Evaluating Respondent Attrition in Web-Based Surveys

Background: Electronic surveys are convenient, cost effective, and increasingly popular tools for collecting information. While the online platform allows researchers to recruit and enroll more participants, there is an increased risk of participant dropout in Web-based research. Often, these dropout trends are simply reported, adjusted for, or ignored altogether. Objective: To propose a conceptual framework that analyzes respondent attrition and demonstrates the utility of these methods with existing survey data. Methods: First, we suggest visualization of attrition trends using bar charts and survival curves. Next, we propose a generalized linear mixed model (GLMM) to detect or confirm significant attrition points. Finally, we suggest applications of existing statistical methods to investigate the effect of internal survey characteristics and patient characteristics on dropout. In order to apply this framework, we conducted a case study; a seventeen-item Informed Decision-Making (IDM) module addressing how and why patients make decisions about cancer screening. Results: Using the framework, we were able to find significant attrition points at Questions 4, 6, 7, and 9, and were also able to identify participant responses and characteristics associated with dropout at these points and overall. Conclusions: When these methods were applied to survey data, significant attrition trends were revealed, both visually and empirically, that can inspire researchers to investigate the factors associated with survey dropout, address whether survey completion is associated with health outcomes, and compare attrition patterns between groups. The framework can be used to extract information beyond simple responses, can be useful during survey development, and can help determine the external validity of survey results

Identifying Attrition Phases in Survey Data: Applicability and Assessment Study

Background: Although Web-based questionnaires are an efficient, increasingly popular mode of data collection, their utility is often challenged by high participant dropout. Researchers can gain insight into potential causes of high participant dropout by analyzing the dropout patterns. Objective: This study proposed the application of and assessed the use of user-specified and existing hypothesis testing methods in a novel setting—survey dropout data—to identify phases of higher or lower survey dropout. Methods: First, we proposed the application of user-specified thresholds to identify abrupt differences in the dropout rate. Second, we proposed the application of 2 existing hypothesis testing methods to detect significant differences in participant dropout. We assessed these methods through a simulation study and through application to a case study, featuring a questionnaire addressing decision-making surrounding cancer screening. Results: The user-specified method set to a low threshold performed best at accurately detecting phases of high attrition in both the simulation study and test case application, although all proposed methods were too sensitive. Conclusions: The user-specified method set to a low threshold correctly identified the attrition phases. Hypothesis testing methods, although sensitive at times, were unable to accurately identify the attrition phases. These results strengthen the case for further development of and research surrounding the science of attrition

A state-level study of opioid use disorder treatment access and neonatal abstinence syndrome

Background Adult opioid use and neonatal abstinence syndrome (NAS) are growing public health problems in the United States (U.S.). Our objective was to determine how opioid use disorder treatment access impacts the relationship between adult opioid use and NAS. Methods We conducted a cross-sectional state-level ecologic study using 36 states with available Healthcare Cost and Utilization Project State Inpatient Databases in 2014. Opioid use disorder treatment access was determined by the: 1) proportion of people needing but not receiving substance use treatment, 2) density of buprenorphine-waivered physicians, and 3) proportion of individuals in outpatient treatment programs (OTPs). The incidence of NAS was defined as ICD-9 code 779.5 (drug withdrawal syndrome in newborn) from any discharge diagnosis field per 1000 live births in that state. Results Unmet need for substance use disorder treatment correlated with NAS (r = 0.54, 95% CI: 0.26–0.73). The correlation between adult illicit drug use/dependence and NAS was higher in states with a lower density of buprenorphine-waivered physicians and individuals in OTPs. Conclusions Measures of opioid use disorder treatment access dampened the correlation between illicit drug use/dependence and NAS. Future studies using community- or individual-level data may be better poised to answer the question of whether or not opioid use disorder treatment access improves NAS relative to adult opioid use

Deconvolution of Hubble Space Telescope images using simulated point spread functions

Presented is a study of the use of simulated point spread functions (PSF's) to deconvolve Hubble Space Telescope images. We concentrate on images from the Wide Field and Planetary Camera (WFPC) and examine the affect of position dependence of the PSF and the telescope focus position on deconvolutions. Comparisons will be made to what will be expected from WFPC 2, which will include corrective optics. Since PSF's can be simulated for any specific observation, with the added advantage of being noise free and the ability to subsample them, they may be more suitable for deconvolution than observed ones in some cases. And since finding a suitable observed PSF may be difficult, simulated ones may be easier to use

HST/ACS Images of the GG Tauri Circumbinary Disk

Hubble Space Telescope Advanced Camera for Surveys images of the young binary GG Tauri and its circumbinary disk in V and I bandpasses were obtained in 2002 and are the most detailed of this system to date. The confirm features previously seen in the disk including: a "gap" apparently caused by shadowing from circumstellar material; an asymmetrical distribution of light about the line of sight on the near edge of the disk; enhanced brightness along the near edge of the disk due to forward scattering; and a compact reflection nebula near the secondary star. New features are seen in the ACS images: two short filaments along the disk; localized but strong variations in disk intensity ("gaplets"); and a "spur" or filament extending from the reflection nebulosity near the secondary. The back side of the disk is detected in the V band for the first time. The disk appears redder than the combined light from the stars, which may be explained by a varied distribution of grain sizes. The brightness asymmetries along the disk suggest that it is asymmetrically illuminated by the stars due to extinction by nonuniform circumstellar material or the illuminated surface of the disk is warped by tidal effects (or perhaps both). Localized, time-dependent brightness variations in the disk are also seen.Comment: 28 pages, 7 figures, accepted for publication in the Astronomical Journa

HST and Spitzer Observations of the HD 207129 Debris Ring

A debris ring around the star HD 207129 (G0V; d = 16.0 pc) has been imaged in scattered visible light with the ACS coronagraph on the Hubble Space Telescope and in thermal emission using MIPS on the Spitzer Space Telescope at 70 microns (resolved) and 160 microns (unresolved). Spitzer IRS (7-35 microns) and MIPS (55-90 microns) spectrographs measured disk emission at >28 microns. In the HST image the disk appears as a ~30 AU wide ring with a mean radius of ~163 AU and is inclined by 60 degrees from pole-on. At 70 microns it appears partially resolved and is elongated in the same direction and with nearly the same size as seen with HST in scattered light. At 0.6 microns the ring shows no significant brightness asymmetry, implying little or no forward scattering by its constituent dust. With a mean surface brightness of V=23.7 mag per square arcsec, it is the faintest disk imaged to date in scattered light.Comment: 28 pages, 8 figure

Harnessing Information Technology to Inform Patients Facing Routine Decisions: Cancer Screening as a Test Case

PURPOSE Technology could transform routine decision making by anticipating patients’ information needs, assessing where patients are with decisions and preferences, personalizing educational experiences, facilitating patient-clinician information exchange, and supporting follow-up. This study evaluated whether patients and clinicians will use such a decision module and its impact on care, using 3 cancer screening decisions as test cases. METHODS Twelve practices with 55,453 patients using a patient portal participated in this prospective observational cohort study. Participation was open to patients who might face a cancer screening decision: women aged 40 to 49 who had not had a mammogram in 2 years, men aged 55 to 69 who had not had a prostate-specific antigen test in 2 years, and adults aged 50 to 74 overdue for colorectal cancer screening. Data sources included module responses, electronic health record data, and a postencounter survey. RESULTS In 1 year, one-fifth of the portal users (11,458 patients) faced a potential cancer screening decision. Among these patients, 20.6% started and 7.9% completed the decision module. Fully 47.2% of module completers shared responses with their clinician. After their next office visit, 57.8% of those surveyed thought their clinician had seen their responses, and many reported the module made their appointment more productive (40.7%), helped engage them in the decision (47.7%), broadened their knowledge (48.1%), and improved communication (37.5%). CONCLUSIONS Many patients face decisions that can be anticipated and proactively facilitated through technology. Although use of technology has the potential to make visits more efficient and effective, cultural, workflow, and technical changes are needed before it could be widely disseminated

Hubble and Spitzer Space Telescope Observations of the Debris Disk around the Nearby K Dwarf HD 92945

[ABRIDGED] We present the first resolved images of the debris disk around the nearby K dwarf HD 92945. Our F606W (V) and F814W (I) HST/ACS coronagraphic images reveal an inclined, axisymmetric disk consisting of an inner ring 2".0-3".0 (43-65 AU) from the star and an extended outer disk whose surface brightness declines slowly with increasing radius 3".0-5".1 (65-110 AU) from the star. A precipitous drop in the surface brightness beyond 110 AU suggests that the outer disk is truncated at that distance. The radial surface-density profile is peaked at both the inner ring and the outer edge of the disk. The dust in the outer disk scatters neutrally but isotropically, and it has a low V-band albedo of 0.1. We also present new Spitzer MIPS photometry and IRS spectra of HD 92945. These data reveal no infrared excess from the disk shortward of 30 micron and constrain the width of the 70 micron source to < 180 AU. Assuming the dust comprises compact grains of astronomical silicate with a surface-density profile described by our scattered-light model of the disk, we successfully model the 24-350 micron emission with a minimum grain size of a_min = 4.5 micron and a size distribution proportional to a^-3.7 throughout the disk, but with a maximum grain size of 900 micron in the inner ring and 50 micron in the outer disk. Our observations indicate a total dust mass of ~0.001 M_earth. However, they provide contradictory evidence of the dust's physical characteristics: its neutral V-I color and lack of 24 micron emission imply grains larger than a few microns, but its isotropic scattering and low albedo suggest a large population of submicron-sized grains. The dynamical causes of the disk's morphology are unclear, but recent models of dust creation and transport in the presence of migrating planets indicate an advanced state of planet formation around HD 92945.Comment: 29 pages, 10 figures; to be published in The Astronomical Journa