Lessons from recruitment to an internet based survey for Degenerative Cervical Myelopathy: merits of free and fee based methods29 Aug 2017
Background: Degenerative Cervical Myelopathy [DCM] is a syndrome of subacute cervical spinal cord compression due to spinal degeneration. Although DCM is common, patient pathways are underdeveloped and a unified treatment approach is lacking. Moreover, fundamental questions, such as the natural history of DCM remain to be answered. The internet has become an attractive tool for medical research, including internet health surveys, with its unrivalled, efficient reach. The most effective recruitment strategy is unknown. Objective: To compare the efficacy of fee based advertisement with alternative free recruitment strategies to a DCM internet health survey. Methods: An internet health survey (Survey Monkey ®), accessed by a new DCM internet platform (myelopathy.org) was created. Using multiple survey collectors and the website Google Analytics ®, the efficacy of fee based recruitment strategies (Google Adwords ®) and free alternatives (including Facebook ®, Twitter ® and Myelopathy.org) were compared. Results: Overall, 772 surveys (513, 66% fully complete) were completed, 305 (40%) from fee based strategies and 455 (59%) from free alternatives. Accounting for researcher time, fee based strategies were more expensive ($7.8/response vs $3.8/response) and identified a less motivated audience (Click-Through-Rate 5% vs 57%) but were more time efficient for the researcher (2mins/response vs 16mins/response). Facebook ® was the most effective free strategy, providing 239 (31%) responses; a single message to 4 existing communities yielded 133 (17%) responses within 7 days. Conclusions: The internet can efficiently reach large numbers of patients. Free and fee based recruitment strategies both have merits. Facebook communities are a rich resource for internet researchers.