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External validity of prevalence estimates from the national maternity surveys in England: The impact of response rate.

ABSTRACT: BACKGROUND:Prevalence estimates from surveys with low response rates are prone to non-response bias if respondents and non-respondents differ on the outcome of interest. This study assessed the external validity of prevalence estimates of selected maternity indicators from four national maternity surveys in England which had similar survey methodology but different response rates. METHODS:A secondary analysis was conducted using data from the national maternity surveys in 2006 (response rate = 63%), 2010 (response rate = 54%), 2014 (response rate = 47%) and 2018 (response rate = 29%). Unweighted and (for the 2014 and 2018 surveys) weighted survey prevalence estimates (with 95%CIs) of caesarean section, preterm birth, low birthweight and breastfeeding initiation were validated against population-based estimates from routine data. RESULTS:The external validity of the survey estimates varied across surveys and by indicator. For caesarean section, the 95%CIs for the unweighted survey estimates included the population-based estimates for all surveys. For preterm birth and low birthweight, the 95%CIs for the unweighted survey estimates did not include the population-based estimates for the 2006 and 2010 surveys (or the 2014 survey for preterm birth). For breastfeeding initiation, the 95%CIs for the unweighted survey estimates did not include the population-based estimates for any survey. For all indicators, the effect of weighting (on the 2014 and 2018 survey estimates) was mostly a shift towards the population-based estimates, yet the 95%CIs for the weighted survey estimates of breastfeeding initiation did not include the population-based estimates. CONCLUSION:There were no clear differences in the external validity of prevalence estimates according to survey response rate suggesting that prevalence estimates may still be valid even when survey response rates are low. The survey estimates tended to become closer to the population-based estimates when weights were applied, yet the effect was insufficient for breastfeeding initiation estimates.

SUBMITTER: Harrison S

PROVIDER: S-EPMC7703875 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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External validity of prevalence estimates from the national maternity surveys in England: The impact of response rate.

Harrison Sian S Alderdice Fiona F Quigley Maria A MA

PloS one 20201130 11

<h4>Background</h4>Prevalence estimates from surveys with low response rates are prone to non-response bias if respondents and non-respondents differ on the outcome of interest. This study assessed the external validity of prevalence estimates of selected maternity indicators from four national maternity surveys in England which had similar survey methodology but different response rates.<h4>Methods</h4>A secondary analysis was conducted using data from the national maternity surveys in 2006 (re ...[more]

PMID: 33253308

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Project description:ObjectivesThe UK faces major problems in retaining general practitioners (GPs). Scotland introduced a new GP contract in April 2018, intended to better support GPs. This study compares the career intentions and working lives of GPs in Scotland with GPs in England, shortly after the new Scotland contract was introduced.Design and settingComparison of cross-sectional analysis of survey responses of GPs in England and Scotland in 2017 and 2018, respectively, using linear regression to adjust the differences for gender, age, ethnicity, urbanicity and deprivation.Participants2048 GPs in Scotland and 879 GPs in England.Main outcome measuresFour intentions to reduce work participation (5-point scales: 1='none', 5='high'): reducing working hours; leaving medical work entirely; leaving direct patient care; or continuing medical work but outside the UK. Four domains of working life: job satisfaction (7-point scale: 1='extremely dissatisfied', 7='extremely satisfied'); job stressors (5-point-scale: 1='no pressure', 5='high pressure); positive and negative job attributes (5-point scales: 1='strongly disagree', 5='strongly agree').ResultsCompared with England, GPs in Scotland had lower intention to reduce work participation, including a lower likelihood of reducing work hours (2.78 vs 3.54; adjusted difference=-0.52; 95% CI -0.64 to -0.41), a lower likelihood of leaving medical work entirely (2.11 vs 2.76; adjusted difference=-0.32; 95% CI -0.42 to -0.22), a lower likelihood of leaving direct patient care (2.23 vs 2.93; adjusted difference=-0.37; 95% CI -0.47 to -0.27), and a lower likelihood of continuing medical work but outside of the UK (1.41 vs 1.61; adjusted difference=-0.2; 95% CI -0.28 to -0.12). GPs in Scotland reported higher job satisfaction, lower job stressors, similar positive job attributes and lower negative job attributes.ConclusionFollowing the introduction of the new contract in Scotland, GPs in Scotland reported significantly better working lives and lower intention to reduce work participation than England.

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External validity of prevalence estimates from the national maternity surveys in England: The impact of response rate.

Publications

External validity of prevalence estimates from the national maternity surveys in England: The impact of response rate.

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