Bias from questionnaire invitation and response in COVID-19 research: an example using ALSPAC

Alba Fernández-Sanlés; Daniel Smith; Gemma L Clayton; Kate Northstone; Alice R Carter; Louise Ac Millard; Maria Carolina Borges; Nicholas John Timpson; Kate Tilling; Gareth J Griffith; Deborah A Lawlor

doi:10.12688/wellcomeopenres.17041.2

Bias from questionnaire invitation and response in COVID-19 research: an example using ALSPAC

Wellcome Open Res. 2022 Jul 8:6:184. doi: 10.12688/wellcomeopenres.17041.2. eCollection 2021.

Authors

Alba Fernández-Sanlés^#^{1

2}, Daniel Smith^#^{1

2}, Gemma L Clayton^{1

2}, Kate Northstone², Alice R Carter^{1

2}, Louise Ac Millard^{1

2}, Maria Carolina Borges^{1

2}, Nicholas John Timpson^{1

2}, Kate Tilling^{1

2}, Gareth J Griffith^{1

2}, Deborah A Lawlor^{1

2

3}

Affiliations

¹ MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
² Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
³ Bristol National Institute of Health Research (NIHR) Biomedical Research Centre, Bristol, UK.

^# Contributed equally.

Abstract

Background: Longitudinal studies are crucial for identifying potential risk factors for infection with, and consequences of, COVID-19, but relationships can be biased if they are associated with invitation and response to data collection. We describe factors relating to questionnaire invitation and response in COVID-19 questionnaire data collection in a multigenerational birth cohort (the Avon Longitudinal Study of Parents and Children, ALSPAC). Methods: We analysed online questionnaires completed between the beginning of the pandemic and easing of the first UK lockdown by participants with valid email addresses who had not actively disengaged from the study. We assessed associations of pre-pandemic sociodemographic, behavioural, anthropometric and health-related factors with: i) being sent a questionnaire; ii) returning a questionnaire; and iii) item response (for specific questions). Analyses were conducted in three cohorts: the index children born in the early 1990s (now young adults; 41 variables assessed), their mothers (35 variables) and the mothers' partners (27 variables). Results: Of 14,849 young adults, 41% were sent a questionnaire, of whom 57% returned one. Item response was >95%. In this cohort, 78% of factors were associated with being sent a questionnaire, 56% with returning one, and, as an example of item response, 20% with keyworker status response. For instance, children from mothers educated to degree-level had greater odds of being sent a questionnaire (OR=5.59; 95% CI=4.87-6.41), returning one (OR=1.60; 95% CI=1.31-1.95), and responding to items (e.g., keyworker status OR=1.65; 95% CI=0.88-3.04), relative to children from mothers with fewer qualifications. Invitation and response rates and associations were similar in all cohorts. Conclusions: These results highlight the importance of considering potential biases due to non-response when using longitudinal studies in COVID-19 research and interpreting results. We recommend researchers report response rates and factors associated with invitation and response in all COVID-19 observational research studies, which can inform sensitivity analyses.

Keywords: ALSPAC; COVID-19; COVID-19 risk factors; Longitudinal Study; Missing Data; Questionnaire Invitation; Questionnaire Response.; Selection Bias.

Abstract

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