Letters
Ethics
Volume 178 - Issue 1

Ethics review and use of reminder letters in postal surveys: are current practices compromising an evidence-based approach?

Author:  Jeanette E Ward

Med J Aust 2003; 178 (1): 43-44. || doi: 10.5694/j.1326-5377.2003.tb05044.x
Published online: 6 January 2003
Download PDF (126 KB)
Share: Share on Blue Sky Share on Facebook Share on LinkedIn Share by email

Comment: Howell and his coauthors invite human research ethics committees (HRECs) to standardise their judgements about key aspects of methods, such as response-aiding strategies.1 Their balanced and thoughtful analysis of their experience in securing approval from two HRECs for reminders to enhance response rates to a postal community survey adds to previous concerns about decision-making by HRECs in Australia.2,3

In an era of evidence-based healthcare, there are two main reasons to insist that HRECs only approve protocols for surveys that propose scientifically based procedures to increase response rates. First, applicants are applying empirical insights from previous research in their own practice. Hence, methods are evidence based. Second, applicants are doing their best to ensure the validity of their future data. As eloquently quantified elsewhere, surveys with low response rates are plagued by response bias.4 Indeed, it was recently asserted that, for mailed surveys, "you need an 80–85% response rate to make it epidemiologically significant".5

Fortunately, there is the most rigorous evidence (Level 1) for specific response-aiding strategies for surveys of medical practitioners in Australia.6 Howell and colleagues cite two recent studies of response-aiding strategies in lay surveys. Yet such compelling evidence appears to have been inadequate to secure identical responses from at least two HRECs. That both required Howell and colleagues to apply "homoeopathic" measures to their reminders (sending two rather than the proven four reminder letters) suggests that these HRECs may have been poorly apprised of the relevant scientific literature, unconvinced of its generalisability, or concerned about the acceptability of proposed procedures to research participants. As current National Health and Medical Research Council (NHMRC) guidelines provide a framework for approving research procedures that are "scientifically justified", it seems HRECs would benefit from regular and independent updates about key methodological advances, such as response-aiding strategies, their benefits, risks and harms.

I am mindful that such methodological guidance must not add unnecessarily to the copious reading that is already typically demanded of members of HRECs. Perhaps the NHMRC Australian Health Ethics Committee could consider this issue in its next triennium, to commence 2003.

Author

  • Jeanette E Ward

References

View this article on Wiley Online Library

More like this

View more