***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background —Few data have evaluated physician adherence to cardiovascular disease ( CVD ) prevention guidelines according to physician specialty or patient characteristics , particularly gender . Methods and Results —An online study of 500 r and omly selected physicians ( 300 primary care physicians , 100 obstetricians/gynecologists , and 100 cardiologists ) used a st and ardized question naire to assess awareness of , adoption of , and barriers to national CVD prevention guidelines by specialty . An experimental case study design tested physician accuracy and determinants of CVD risk level assignment and application of guidelines among high- , intermediate- , or low-risk patients . Intermediate-risk women , as assessed by the Framingham risk score , were significantly more likely to be assigned to a lower-risk category by primary care physicians than men with identical risk profiles ( P<0.0001 ) , and trends were similar for obstetricians/gynecologists and cardiologists . Assignment of risk level significantly predicted recommendations for lifestyle  and preventive pharmacotherapy . After adjustment for risk assignment , the impact of patient gender on preventive care was not significant except for less aspirin ( P<0.01 ) and more weight management recommended ( P<0.04 ) for intermediate-risk women . Physicians did not rate themselves as very effective in their ability to help patients prevent CVD . Fewer than 1 in 5 physicians knew that more women than men die each year from CVD . Conclusions —Perception of risk was the primary factor associated with CVD preventive recommendations . Gender disparities in recommendations for preventive therapy were explained largely by the lower perceived risk despite similar calculated risk for women versus men . Educational interventions for physicians are needed to improve the quality of CVD preventive care and lower morbidity and mortality from CVD for men and women PURPOSE This study compared the response time , response rate , and cost of two types of survey administration techniques : e-mail/web-based versus conventional postal mail . The main aim of the survey was to collect descriptive information on the existence of Acute Care for Elders units and their characteristics by surveying geriatric division chiefs . DESIGN AND METHODS Two r and omized cohorts of geriatric division chiefs were formed to receive a survey either by electronic mail ( n = 57 ) or by  conventional postal mail ( n = 57 ) . If there was no response to the initial mailing , two follow-up mailings were sent to both groups using the original modality ; a third follow-up was performed using the alternative modality . For each group , response rate and response time were calculated . The average total cost was computed and compared across two groups . RESULTS The aggregate response rate was 58 % ( n = 31 ) for the e-mail group versus 77 % ( n = 44 ) for the postal mail group . The overall average response time was shorter in the e-mail group , 18 days compared with 33 days for the conventional postal mailing group . The cost comparison showed that average cost was $ 7.70 for the e-mail group , compared to $ 10.50 per response for the conventional mail group . IMPLICATION S It appears that although the web-based technology is gaining popularity and leads to lower cost per response , the conventional postal method of surveying continues to deliver a better response rate among the geriatric medicine division chiefs . The web-based approach holds promise given its lower costs and acceptable response rate combined with the shorter response time The objective of this study was to compare the impact of closed- versus open-ended question formats on the completeness and accuracy of demographic data collected in a mailed survey question naire . We surveyed general internists in five Canadian provinces to determine their career satisfaction . We r and omized respondents to receive versions of the question naire in which 16 demographic questions were presented in a closed-ended or open-ended format . Two questions required respondents to make a relatively simple computation ( ensuring that three or four categories of response added to 100 % ) . The  response rate was 1007/1192 physicians ( 80.0 % ) . The proportion of respondents with no missing data for all 16 questions was 44.7 % for open-ended and 67.0 % for closed-ended formats ( P < 0.001 ) . The odds of having missing items remained higher for open-ended response options after adjusting for a number of respondent characteristics ( 2.67 , 95 % confidence interval 2.01 to 3.55 ) . For the two questions requiring computations focused on professional activity and income , there were more missing data ( P = 0.02 , 0.02 , respectively ) but fewer inaccurate responses ( P = 0.009 , 0.20 , respectively ) for the open-ended compared to the closed-ended format . Investigators can achieve higher response rates for demographic items using closed format response options , but at the risk of increasing inaccuracy in response to questions requiring computation OBJECTIVES The effects of incentive size on physicians '  response rates to a mail survey were determined . METHODS One thous and US primary care physicians were assigned r and omly to receive a survey with either a $ 5 bill or a $ 2 bill as an incentive . For each of the two incentive groups , the overall response rate for three mailing waves , the total cost , and the total cost per usable response were measured . RESULTS The response rate among those receiving the $ 5 bill ( 61 % ) was 32 % higher than the response rate among those receiving the $ 2 bill ( 46 % ) ; overall costs were slightly higher in the $ 5 group , but the cost per response for each group was similar ( $ 15.46 versus $ 14.93 ) . For the same cost , a higher response rate could have been achieved in the $ 2 group if costs saved from foregoing the third mailing were instead used to increase the incentive for a portion of the subjects . CONCLUSIONS A $ 5 bill incentive yielded a higher response rate among the physicians in this study than did a $ 2 bill incentive . Moreover , the powerful effect of the incentive size , combined with the consequent decline in the costs of subsequent mailing waves , suggests that re sources in a fixed survey budget are allocated more efficiently to increasing the initial incentive rather than to providing a third wave to nonresponders BACKGROUND Historically , achieving a high response rate on physician surveys has been a challenging task . Given such concerns , underst and ing research strategies that facilitate adequate response rates is important . Primary care physician responses to a mail survey on smoking cessation are summarized by physician specialty and timing of incentive . METHODS A stratified r and om- sample design , stratified by patient population s-adults , adolescents , and pregnant women-was used . The sampling frame included New Jersey internists , general practitioners , family physicians , pediatricians , and obstetrician-gynecologists . A total of 2100 physicians , 700 physicians from each patient strata , were sample d and mailed a smoking-cessation survey in summer 2002 . The sample was r and omized by incentive timing : Half received the incentive ( i.e. , 25 dollars gift card ) with the first survey mailing , and half received the incentive on receipt of their completed survey . RESULTS The promised-incentive group achieved a significantly lower response rate ( 56 % ) compared with the up-front-incentive group ( 71.5 % ) . Response rates by medical specialty varied overall and within incentive groups . The difference between the incentive groups was greatest among obstetrician-gynecologists ( i.e. , 20.2 percentage points ) and was least among pediatricians ( i.e. , 5.8 percentage points ) . CONCLUSIONS Physician response rates to mail surveys are greatly improved , especially among certain medical specialties , by using up-front incentives Background Low response rates among surgeons can threaten the validity of surveys . Internet technologies may reduce the time , effort , and financial re sources needed to conduct surveys . Objective We investigated whether using Web-based technology could increase the response rates to an international survey . Methods We solicited opinions from the 442 surgeon – members of the Orthopaedic Trauma Association regarding the treatment of femoral neck fractures . We developed a self-administered question naire after conducting a literature review , focus groups , and key informant interviews , for which we used sampling to redundancy techniques . We administered an Internet version of the question naire on a Web site , as well as a paper version , which looked similar to the Internet version and which had identical content . Only those in our sample could access the Web site . We alternately assigned the participants to receive the survey by mail ( n=221 ) or an email invitation to participate on the Internet ( n=221 ) . Non-respondents in the mail arm received up to three additional copies of the survey , while non-respondents in the Internet arm received up to three additional requests , including a final mailed copy . All participants in the Internet arm had an opportunity to request an emailed Portable Document Format ( PDF ) version . Results The Internet arm demonstrated a lower response rate ( 99/221 , 45 % ) than the mail question naire arm ( 128/221 , 58 % ) ( absolute difference 13 % , 95 % confidence interval 4%-22 % , P<0.01 ) . Conclusions Our Internet-based survey to surgeons result ed in a significantly lower response rate than a traditional mailed survey . Research ers should not assume that the widespread availability and potential ease of Internet-based surveys will translate into higher response rates In 1989 , the authors tested the effectiveness of two response-enhancing techniques , a postage stamped or franked return envelope and a prenotification letter , in a survey of pregnancy among 10,047 resident physicians in the United States . The techniques were r and omly assigned using a factorial design . No significant interactions were observed between the techniques . After two mailings , those who received a stamped return envelope had a response of 71.2 % , compared with 68.2 % for those who received a franked return envelope ( 95 % confidence interval 1.3 - 4.9 % ) . Men who received the stamped envelope had a 5.9 % greater response than those who received the franked envelope ( p less than 0.001 ) , but the type of postage did not influence response among women ( p = 0.84 ) ; this interaction was statistically significant ( p = 0.006 ) . Physicians who received a prenotification letter had a response of 69.0 % , compared with 70.5 % for those who did not receive the letter ( 95 % confidence interval -3.3 to 0.2 % ) . The authors conclude that seemingly minor changes in survey design could have saved from 12 % to 19 % of the total cost of the study OBJECTIVES To compare 3 communication modes ( postal , fax , and e-mail ) in a rotavirus vaccine physician survey . METHODS We used 3 communication modes to distribute a survey to physicians listed in the membership directory of the Georgia Chapter of the American Academy of Pediatrics . The directory listed 1391 members ; however , 404 were deemed ineligible on the basis of their listing as a specialist , retiree , resident in training , or government public health employee . Of the 987 members expected to administer vaccines , 150 were selected r and omly to receive the postal survey ( postal group ) . Of the remaining listings , 488 ( 58 % ) of 837 listed a fax number ; 150 members were selected r and omly and faxed a survey ( fax group ) . Of the remaining members , 266 ( 39 % ) of 687 had e-mail addresses listed ; 150 members were selected r and omly for the e-mail survey ( e-mail group ) . A follow-up survey was sent by the same mode at 2 weeks . A final survey was sent via another mode ( mixed mode ) at 1 month : by fax to e-mail and postal nonresponders and by post to fax nonresponders and those without fax . RESULTS Eligible respondents in the 3 survey groups were similar in their practice setting and location . Although the e-mail group had fewer median years ( 8 years ) since medical school graduation than the fax group ( 19 years ) and postal group ( 17 years ) , a similar percentage of responders in all groups had computers ( > 85 % ) and Internet access ( > or = 70 % ) at work . However , only 39 % of members listed an e-mail address in the directory . In the 2 weeks after the first mailing , 39 surveys were completed via postal mail , 50 via fax , and 16 via e-mail . In the 2 weeks after the second contact ( sent at 2 weeks ) , 20 surveys were completed via postal mail , 15 via fax , and 17 via e-mail . The response rate after the first 2 mailings was 41 % ( 59 of 143 ) for postal , 47 % ( 65 of 137 ) for fax , and 26 % ( 33 of 125 ) for e-mail surveys . The third and final survey ( sent 1 month after the first mailing ) was sent by a different ( ie , mixed ) mode and elicited an additional 73 responses : 19 responses ( 15 postal , 4 fax ) from the postal group , 19 responses ( 18 postal , 1 fax ) from the fax group , and 35 responses ( 15 postal , 13 fax , 7 e-mail ) from the e-mail group . Twenty-three percent ( 9 of 40 ) of the e-mail and 18 % ( 15 of 83 ) of the fax surveys completed were returned on the same or subsequent day they were sent , compared with none of the postal surveys . There were significant differences among the 3 groups for invalid addresses/numbers ( 4 % postal , 8 % fax , and 16 % e-mail ) listed in the directory . Using mixed modes as the third contact , the overall response rate increased from 39 % before mixed mode to a final of 53 % . On the basis of the 3 initial groups , responses to 1 of 12 rotavirus questions differed significantly . CONCLUSIONS Future use of e-mail surveys in selected circumstances is promising , because the majority of prov 
    Output:
    
Even small financial incentives were found to be effective in improving physician response .
Token nonmonetary incentives were much less effective .
In terms of design strategies , postal and telephone strategies have generally been more successful than have fax or Web-based approaches , with evidence also supporting use of mixed-mode surveys in this population .
In addition , use of first-class stamps on return envelopes and question naires design ed to be brief , personalized , and endorsed by legitimizing professional associations were also more likely to be successful .