title: Minimizing Attrition for Multisite Emergency Care Research.
abstract: Loss to follow-up of enrolled patients (a.k.a. attrition) is a major threat to study validity and power. Minimizing attrition can be challenging even under ideal research conditions, including the presence of adequate funding, experienced study personnel, and a refined research infrastructure. Emergency care research is shifting toward enrollment through multisite networks, but there have been limited descriptions of approaches to minimize attrition for these multicenter emergency care studies. This concept paper describes a stepwise approach to minimize attrition, using a case example of a multisite emergency department prospective cohort of over 3,000 patients that has achieved a 30-day direct phone follow-up attrition rate of <3%. The seven areas of approach to minimize attrition in this study focused on patient selection, baseline contact data collection, patient incentives, patient tracking, central phone banks, local enrollment site assistance, and continuous performance monitoring. Appropriate study design, including consideration of these methods to reduce attrition, will be time well spent and may improve study validity.
authors.affiliation: Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
authors.forename: Bret A
authors.initials: BA
authors.lastname: Nicks
authors.affiliation: Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI.
authors.forename: Manish N
authors.initials: MN
authors.lastname: Shah
authors.affiliation: Department of Emergency Medicine, University of Rochester, Rochester, NY.
authors.forename: David H
authors.initials: DH
authors.lastname: Adler
authors.affiliation: Department of Emergency Medicine, William Beaumont Hospital-Troy, Troy, MI.
authors.forename: Aveh
authors.initials: A
authors.lastname: Bastani
authors.affiliation: Department of Emergency Medicine, Brigham & Women's Hospital, Boston, MA.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Baugh
authors.affiliation: Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Caterino
authors.affiliation: Department of Emergency Medicine, William Beaumont Hospital-Royal Oak, Royal Oak, MI.
authors.forename: Carol L
authors.initials: CL
authors.lastname: Clark
authors.affiliation: Department of Emergency Medicine, University of Texas-Southwestern, Dallas, TX.
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Diercks
authors.affiliation: Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Judd E
authors.initials: JE
authors.lastname: Hollander
authors.affiliation: Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Heath & Science University, Portland, OR.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Malveau
authors.affiliation: Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA.
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Nishijima
authors.affiliation: Department of Emergency Medicine, Summa Health System, Akron, OH.
authors.forename: Kirk A
authors.initials: KA
authors.lastname: Stiffler
authors.affiliation: Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Alan B
authors.initials: AB
authors.lastname: Storrow
authors.affiliation: Department of Emergency Medicine, Summa Health System, Akron, OH.
authors.forename: Scott T
authors.initials: ST
authors.lastname: Wilber
authors.affiliation: Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Heath & Science University, Portland, OR.
authors.forename: Annick N
authors.initials: AN
authors.lastname: Yagapen
authors.affiliation: Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Heath & Science University, Portland, OR.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Sun
mesh_terms: D000359:Aftercare / Q000706:statistics & numerical data*; D000368:Aged; D003625:Data Collection / Q000379:methods; D004632:Emergency Medical Services; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010352:Patient Dropouts; D018579:Patient Selection; D011446:Prospective Studies