Randomized trial showed requesting medical records with a survey produced a more representative sample than requesting separately.

OBJECTIVES

The objective of the study was to compare the effect of two approaches to requesting medical records on survey response rates, sample representativeness, and the quality of self-reported screening.

STUDY DESIGN AND

SETTING

Eight hundred ninety veterans aged 50-75 years from the Minneapolis VA Medical Center were randomly assigned to (1) records request included with a colorectal cancer screening survey ("with-survey" group) or (2) request in a separate mailing following a completed survey ("after-survey" group). Analyses compared response rates, the proportion and characteristics of patients providing records, and the validity of self-reported screening, by group.

RESULTS

Response rates did not vary by group (with-survey 76%; after-survey 78%, P=0.45). 54% of with-survey and 47% of after-survey participants provided complete medical records (P = 0.06). In the with-survey group, patients with complete medical records were significantly more likely to be married and to have a diagnosis of posttraumatic stress disorder; in the after-survey group, they were more likely to be aged 65-75 years, Caucasian, to have a family history of colorectal cancer, and to report being screened. Validity of self-reported screening did not vary significantly by group.

CONCLUSION

The with-survey approach did not significantly reduce response rates or the quality of self-reported screening and produced a higher number and more representative sample with complete records.