Randomized trial showed requesting medical records with a survey produced a more representative sample than requesting separately

Objectives: The objective of the study was to compare the effect of two approaches to requesting medical records on survey response rates, sample representativeness, and the quality of self-reported screening. Study Design and Setting: Eight hundred ninety veterans aged 50-75 years from the Minneapolis VA Medical Center were randomly assigned to (1) records request included with a colorectal cancer screening survey ("with-survey" group) or (2) request in a separate mailing following a completed survey ("after-survey" group). Analyses compared response rates, the proportion and characteristics of patients providing records, and the validity of self-reported screening, by group. Results: Response rates did not vary by group (with-survey 76%; after-survey 78%, P = 0.45). 54% of with-survey and 47% of after-survey participants provided complete medical records (P = 0.06). In the with-survey group, patients with complete medical records were significantly more likely to be married and to have a diagnosis of posttraumatic stress disorder; in the after-survey group, they were more likely to be aged 65-75 years, Caucasian, to have a family history of colorectal cancer, and to report being screened. Validity of self-reported screening did not vary significantly by group. Conclusion: The with-survey approach did not significantly reduce response rates or the quality of self-reported screening and produced a higher number and more representative sample with complete records.