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Original research
Review of response rates over time in registry-based studies using patient-reported outcome measures
  1. Katherine Wang1,2,
  2. Cathrine N Eftang3,
  3. Rune Bruhn Jakobsen4,5,
  4. Asbjørn Årøen5,6
  1. 1University of Oslo Faculty of Medicine, Oslo, Norway
  2. 2Oslo Sports Trauma Research Center, Oslo, Norway
  3. 3Department of Pathology, Akershus University Hospital, Lorenskog, Norway
  4. 4Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway
  5. 5Department of Orthopaedic Surgery, Akershus University Hospital, Lorenskog, Norway
  6. 6Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway
  1. Correspondence to Katherine Wang; wkath8{at}


Objectives Gain an overview of expected response rates (RRs) to patient-reported outcome measures (PROMs) in clinical quality registry-based studies and long-term cohorts in order to better evaluate the validity of registries and registry-based studies. Examine the trends of RRs over time and how they vary with study type, questionnaire format, and the use of reminders.

Design Literature review with systematic search.

Data sources PubMed, MEDLINE, EMBASE,, and

Eligibility criteria Articles in all areas of medical research using registry-based data or cohort design with at least two follow-up time points collecting PROMs and reporting RRs. Annual reports of registries including PROMs that report RRs for at least two time points.

Primary outcome measure RRs to PROMs.

Results A total of 10 articles, 12 registry reports and 6 registry articles were included in the review. The overall RR at baseline was 75%±22.1 but decreased over time. Cohort studies had a markedly better RR (baseline 97%±4.7) compared with registry-based data at all time points (baseline 72%±21.8). For questionnaire formats, paper had the highest RR at 86%±19.4, a mix of electronic and paper had the second highest at 71%±15.1 and the electronic-only format had a substantially lower RR at 42%±8.7. Sending one reminder (82%±16.5) or more than one reminder (76%±20.9) to non-responders resulted in a higher RR than sending no reminders (39%±6.7).

Conclusions The large variation and downward trend of RRs to PROMs in cohort and registry-based studies are of concern and should be assessed and addressed when using registry data in both research and clinical practice.

  • registries
  • patient reported outcome measure
  • PROM
  • response rate

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors CNE, RBJ and AÅ devised the project and the main conceptual ideas. CNE and KW performed the searches and data extraction. KW analysed the data and wrote the manuscript with support from CNE and consultation with RBJ and AÅ.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository. Extra data can be accessed via the Dryad data repository at with the doi: 10.5061/dryad.hhmgqnkcp.

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