A study of mail survey method.

A major disadvantage of the mail survey in medical research is non-response, which may introduce bias. This study measured the effect of two simple factors on the response rate to a questionnaire concerning headache and migraine in a survey of 2,508 electors. The two factors were the class of postage and the colour of envelopes used; neither was found to have a significant effect. It was concluded that cheaper mailing methods are not likely to jeopardise response.

Does anonymity increase response rate in postal questionnaire surveys about sensitive subjects? A randomised trial.

STUDY OBJECTIVE: The aim of the study was to determine whether complete anonymity improves the response rates to a postal questionnaire. DESIGN: The study derived from a series of postal surveys on AIDS knowledge conducted on six different dates in 1986 and 1987. The sample was randomly divided into two, each group being sent the same questionnaire. One group was informed that the replies were anonymous, the other that they were not. The latter were sent reminders. SETTING: Recipients of the questionnaires were drawn from the Southampton electoral rolls. PARTICIPANTS: 300 people in each survey (total 1800) were sent questionnaires, representing on each occasion a different 1:500 systematic sample. RESULTS: Response rate was 49% for the anonymous questionnaires and 51% for the numbered questionnaires. Reminders boosted the response in the numbered group to 72%. CONCLUSIONS: There is no evidence that anonymity improves response to postal questionnaires, but the use of reminders may do so.

Chest pain in women: a study of prevalence and mortality follow up in south Wales.

The London School of Hygiene cardiovascular questionnaire was administered by interviewers in a community survey of 1428 women aged 45-74 living in the Rhondda Fach in south Wales. The results were analysed after a 12 year follow up for mortality. The prevalence of angina was similar to that of a Swiss population, where the method of administration of the questionnaire was similar. The risk of dying associated with angina was some 50% higher than that for women without angina, significant at the 5% level. The risk was greatest for women aged 45-54 when angina accounted for some 15% of deaths in the follow up period. Grade 2 angina was associated with a higher mortality from coronary heart disease, with more than double the risk. The overall risk of dying associated with angina did not appear to decline with time.

A useless raffle.

A mailed questionnaire was sent to 2712 subjects asking about respiratory symptoms, and a raffle for three prizes of 50 pounds, 30 pounds, and 20 pounds was organised. The response rate in the 1762 who were told about the raffle was no higher than for 950 subjects who served as controls.

Prescription information leaflets: a national survey.

Three thousand four hundred and ten patients recruited at 254 pharmacies took part in a national postal survey of the effect of prescription information leaflets. The patients had been prescribed penicillins, non-steroidal anti-inflammatory drugs (NSAIDs) or beta-adrenoceptor antagonists. The 1809 patients who received leaflets knew more about their medicines, especially the side effects and were significantly more satisfied than the 1601 patients who were not given additional written information. The leaflets were found to be effective when issued in the north, in the south and in small, medium and large towns. Patients of both sexes, all age groups and social classes were found to benefit from the leaflets and almost everyone (97%) thought they were a good idea. These results confirm and extend our previous findings and add further support for the routine use of information leaflets with prescribed medicines.

Teaching epidemiology to the medical student.

The time allocated to epidemiology in the medical curriculum of most medical schools has increased and its importance has gained more general acceptance. The reason "Why?" epidemiology should be taught is perhaps best given by the World Health Organisation's report that epidemiology should aim to influence the future doctor's attitude to the problems of health and disease in the community by making the student more aware of the scientific approach to those problems. The question "How?" epidemiology should be taught is more difficult and there is evidence, at least from the United Kingdom, that the subject is regarded as both dull and the least difficult of sixteen subjects investigated. The question of whether epidemiology should be taught as a separate discipline or integrated into the curriculum is perhaps best answered by saying both should be done. The methods of instruction vary and a combination of methods is desirable in any course. The relations between epidemiology and other subjects and the place of epidemiology in formal examinations, varies greatly between medical schools. The ideal solutions to these and other problems still lie in the future.

Controlled clinical trial of ergotamine tartrate.

A double-blind controlled clinical trial of cross-over design for the treatment of headache was conducted in 88 women identified during a community survey as having headaches with the features of migraine. Of 79 subjects who completed the trial, 40 benefited from oral ergotamine tartrate and 46 benefited from the placebo. There was no evidence that ergotamine in doses of 2 or 3 mg. was more effective than the placebo. Ergotamine aggravated the attack significantly more often than the placebo. Neither the colour of the tablets nor the order of therapy significantly affected the results of the treatment.

Migraine in general practitioners.

A self-administerd questionnaire was posted to 1 129 medical general practitioners in an urban and in a rural area of England. The prevalences of headache, and of the features of migraine, in the year immediately preceding the survey were similar in the two areas. After allowing for the different age and sex composition of the populations, these prevalences were also similar to those found in the general population during an early survey in Wales. About 13% of the male and 25% of the female general practitioners thought that they had had migraine in the previous year. There was little evidence that doctors with 'classic' migraine differed from those with 'common' migraine in the proportion who experienced other migrainous features (unilateral distribution of headache and accompanying nausea) or in their response to treatment with ergotamine.