Questionnaire order significantly increased response to a postal survey sent to primary care physicians

J Clin Epidemiol. 2008 Feb;61(2):177-85. doi: 10.1016/j.jclinepi.2007.04.012. Epub 2007 Aug 24.


Objective: Primary care physicians are increasingly being asked to participate in postal surveys. Difficulties in achieving adequate response rates among physicians have been reported. We investigated the effect of two low-cost interventions on response to a primary care physician postal questionnaire.

Study design and setting: A 2x2 factorial trial was developed within the context of a national survey assessing views and practices of physicians regarding prostate-specific antigen testing. We evaluated questionnaire order (version 1: demographics first, version 2: topic-specific questions first) and written precontact. A national database of primary care physicians was compiled. One thousand five hundred ninety-nine physicians were randomly selected, stratified by health board, and randomized.

Results: 47.9% of eligible physicians completed a questionnaire. There was a statistically significant 5.1% higher response rate among physicians receiving version 1 of the questionnaire than those receiving version 2 (50.6% vs. 45.4%, P=0.05); the adjusted odds of response were significantly raised (odds ratio=1.24; 95% confidence interval=1.01-1.54). Precontact resulted in a nonsignificant 3.6% increase in response (49.8% vs. 46.2%; P=0.16). The interventions did not interact.

Conclusion: Ordering questionnaires with general questions first can significantly increase response rates, whereas precontact can achieve a modest increase. These strategies may enhance response while adding little to the cost of a physician survey.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel*
  • Cooperative Behavior
  • Female
  • Health Care Surveys / methods*
  • Humans
  • Ireland
  • Male
  • Physicians, Family / psychology*
  • Postal Service
  • Professional Practice / statistics & numerical data
  • Prostate-Specific Antigen / blood
  • Psychometrics
  • Surveys and Questionnaires*


  • Prostate-Specific Antigen