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Katsuno N, Li PZ, Bourbeau J, Aaron S, Maltais F, Hernandez P, Chapman KR, Walker B, Marciniuk DD, ODonnell DD, Sin DD, Hogg JC, Cheng M, Road J, Tan WC. Factors Associated with Attrition in a Longitudinal Cohort of Older Adults in the Community. Chronic Obstr Pulm Dis 2023; 10:178-189. [PMID: 37099700 PMCID: PMC10392873 DOI: 10.15326/jcopdf.2022.0380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Introduction Retaining participants in longitudinal studies increases their power. We undertook this study in a population-based longitudinal cohort of adults with COPD to determine the factors associated with increased cohort attrition. Methods In the longitudinal population-based Canadian Cohort of Obstructive Lung Disease (CanCOLD) study, 1561 adults > 40 years old were randomly recruited from 9 urban sites. Participants completed in-person visits at 18-month intervals and also were followed up every 3 months over the phone or by email. The cohort retention for the study and the reasons for attrition were analyzed. Hazard ratios and robust standard errors were calculated using Cox regression methods to explore the associations between participants who remained in the study and those who did not. Results The median follow-up (years) of the study is 9.0 years. The overall mean retention was 77%. Reasons for attrition (23%) were: dropout by participant (39%), loss of contact (27%), investigator-initiated withdrawal (15%), deaths (9%), serious disease (9%), and relocation (2%). Factors independently associated with attrition were lower educational attainment, higher pack-year tobacco consumption, diagnosed cardiovascular disease, and a higher Hospital Anxiety and Depression Scale score: adjusted hazard ratios (95% confidence interval) were 1.43(1.11, 1.85); 1.01(1.00, 1.01); 1.44(1.13, 1.83); 1.06(1.02, 1.10) respectively. Conclusions Identification and awareness of risk factors for attrition could direct targeted retention strategies in longitudinal studies. Moreover, the identification of patient characteristics associated with study dropout could address any potential bias introduced by differential dropouts.
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Affiliation(s)
- Noah Katsuno
- University of British Columbia, Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Pei Z Li
- Research Institute, McGill University Health Centre, McGill University, Montreal, Quebec Canada
| | - Jean Bourbeau
- Research Institute, McGill University Health Centre, McGill University, Montreal, Quebec Canada
| | - Shawn Aaron
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Francois Maltais
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Paul Hernandez
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Brandie Walker
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Darcy D Marciniuk
- Respiratory Research Centre, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Don D Sin
- University of British Columbia, Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - James C Hogg
- University of British Columbia, Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Michael Cheng
- University of British Columbia, Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Jeremy Road
- Department of Medicine, University of British Columbia and Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - Wan C Tan
- University of British Columbia, Centre for Heart Lung Innovation, St Paul's Hospital, Vancouver, British Columbia, Canada
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