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From children and parents who finally refuse to participate in the study gender, age, weight status and reason of refusal are recorded.
Asked for the reason of refusal, all denying school's directors argued that their schools would already participate in other studies and/or are overloaded.
Data including reason of refusal, reason of proposal, subjective evaluation of clinicians and outcome at hospital discharge and three months later were collected in the standardized case-report form.
The main reason of refusal was that the hospital already participated in another patient survey.
Interestingly, asking the sampled subjects to mention otherwise the reason of refusal was helpful as a prior exploration of non-participation.
Israel has a strong family-oriented culture, so a major role in grandparenting has been the primary reason of refusal of women to participate in the study.
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Reasons of refusal were no beds availability (76.2%), too sick to benefit from ICU (13%), too well (9.4%) and necessity of other exploration (1.4%).
Between wave 4 and 5, 130 respondents died and 52 respondents were not interviewed at wave 5 for reasons of refusal (other reasons: n = 69).
Less important reasons of refusal were additional costs, or possible data loss and other data protection problems (Table 4 "additional costs" and "data protection").
Although a weighting procedure was used to make the sample as representative of the general population in Lebanon as possible, there was still a possibility of a selection bias because there was no means to evaluate the reasons of refusal, which could have lead to an overestimation or underestimation of the COPD prevalence.
In our ICU, the refusals are usually recorded with a specific form collecting the identities of the patient and the calling doctor, the reason for referral (ethical advisory or medical referral), a short medical history and the reason(s) of refusal.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com