Factors Related to Dropout in a Study of Head and Neck Cancer Patients after Surgery

Abstract

The extent and nature of dropout was assessed in a longitudinal study whose objective was to define and quantify the functional effects of oral surgical resection and reconstruction on speech and swallowing function in patients with head and neck cancer. Of 150 patients who were enrolled to be followed up with speech and swallow assessments for 1 year after surgery, 113 (75%) dropped out and 37 (25%) returned to complete the study at the final 12-month evaluation point. In general, those completing the study had a smaller resection than the patients who dropped out before the 12-month evaluation. Fifty percent of the dropout was accounted for by medical reasons, 23% by administrative reasons, and 27% by patient-specific reasons (ie, reasons known only to the patient). Analysis of the dropout categories revealed that higher cancer stage, larger volume of resection, and having a flap surgical closure versus a primary closure or skin graft increased a patient's chance of dropping out. A larger volume of resection was also related to an increased chance of being a patient-specific dropout. Patients who reported no or low alcohol usage had a greater chance of completing follow-up than being a patient-specific dropout.

Get full access to this article

View all access options for this article.

References

Ellenberg

. Selection bias in observational and experimental studies. Stat Med 1994;13:557–67.

Robles

Flaherty

Day

. Retention of resistant subjects in longitudinal studies: Description and procedures. Am J Drug Alcohol Abuse 1994;20:87–100.

Kahl

Fischbach

Schwarze

. How to deal with the dropout in clinical follow-up studies: Results of a long-term follow-up study of orthodontically treated patients. Am J Orthod Dentofacial Orthop 1995;108:415–20.

Hansen

Collins

Malotte

et al. Attrition in prevention research. J Behav Med 1985;8:261–75.

Blouin

Schnarre

Carter

et al. Factors affecting dropout rate from cognitive-behavioral group treatment for bulimia nervosa. Int J Eat Disord 1995;17:323–9.

Blumenthal

Sung

Coates

et al. Recruitment and retention of subjects for a longitudinal cancer prevention study in an inner-city black community. Health Serv Res 1995;30:197–205.

Dudley

Jin

Hoover

et al. The multicenter AIDS cohort study: Retention after 9½ years. Am J Epidemiol 1995;142:323–30.

Marmor

Oliveria

Donahue

et al. Factors encouraging cohort maintenance in a longitudinal study. J Clin Epidemiol 1991;44:531–5.

Slymen

Drew

Wright

et al. Compliance with a 12-month assessment in an elderly cohort participating in a preventive intervention study: The San Diego Medicare Preventive Health Project. Int J Epidemiol 1992;21:701–6.

10.

Logemann

Pauloski

Rademaker

et al. Speech and swallow function after tonsil/base of tongue resection with primary closure. J Speech Hear Res 1993;36:918–26.

11.

Pauloski

Logemann

Rademaker

et al. Speech and swallowing function after anterior tongue and floor of mouth resection with distal flap reconstruction. J Speech Hear Res 1993;36:267–76.

12.

Hosmer

Lemeshow

. Applied logistic regression. New York: John Wiley; 1989.

13.

SAS Institute Inc. SAS/STAT user's guide. Version 6. 4th ed. Vol 1. Cary (NC): SAS Institute; 1989.

14.

Hill

. Principles of medical statistics. 9th ed. New York: Oxford University Press; 1971.

15.

McFadden

LoPresti

Bailey

et al. Approaches to data management. Control Clin Trials 1995;16:30S–65S.

16.

List

Ritter-Sterr

Lansky

. A performance status scale for head and neck cancer patients. Cancer 1990;66:564–9.