Affect Response Rates Research Articles

How Contextual Cues Impact Response and Conversion Rates of Online Surveys

This study investigates how three contextual cues—researcher identity, sponsor identity, and incentive type—affect response and conversion rates of online conversion surveys. Applying an experimental design via an online survey of information inquirers to a tourist destination, the study demonstrates that researcher identity and sponsor identity affect the response rates, and the specific arrangement can increase the response rate substantially. The three contextual cues do not affect conversion rates significantly.

Interactive voice response - an automated follow-up technique for adolescents discharged from acute psychiatric inpatient care: a randomised controlled trial

Follow-up methods must be easy for young people to handle. We examine Interactive Voice Response (IVR) as a method for collecting self-reported data. Sixty inpatients were recruited from a child and adolescent psychiatric emergency unit in Malmö, Sweden and called every second (N = 30) or every fourth (N = 30) day from discharge until first visit in outpatient care. A pre-recorded voice asked them to evaluate their current mood using their mobile phones. Average response rate was 91%, and 71% had a 100% response rate. Gender, age and length of inpatient treatment did not affect response rate, nor did randomisation. Boys estimated their current mood on average as 3.52 units higher than girls, CI = (2.65, 4.48). Automated IVR is a feasible method of collecting follow-up data among adolescents discharged from a psychiatric emergency unit.

Evaluation of Melphalan 1-Day Versus 2-Day Dosing in Patients with Multiple Myeloma Undergoing Autologous Stem Cell Transplantation

Multiple myeloma (MM) is the most common plasma cell disorder with an incidence of 4-5 new cases per 100,000 individuals per year. High dose chemotherapy with melphalan followed by autologous stem cell transplantation (SCT) is considered the standard of care. Melphalan 200 mg/m2 is considered the gold standard conditioning regimen prior to autologous SCT. The Intergroupe Francophone du Myélome randomized trial confirmed that patients receiving melphalan 200 mg/m2 displayed a better median overall survival as compared to patients treated with melphalan 140 mg/m2 in combination with total body irradiation (65 vs. 45% survival at 45 months). Melphalan 200 mg/m2 has been administered over 1-day or given over two consecutive days (100 mg/m2 per day). Limited data exist on optimal schedule of dosing and to date, direct comparative efficacy analyses have not been conducted between 1-day versus 2-day melphalan administration. As of March 2012, the Blood and Marrow Transplantation Service at Moffitt Cancer Center changed the melphalan conditioning regimens from 2-day dosing (100 mg/m2 per day) to 1-day dosing (200 mg/m2per day). An evaluation will be performed in order to determine if there is a difference in the effects on patients’ transplant complications, engraftment, and response rates between the two groups. The dose-limiting toxicity of melphalan is oral mucositis which is associated with prolonged hospitalization. Grazziutti, et al found that higher melphalan doses and renal dysfunction (both reflecting increased melphalan exposure) were key pre-transplant risk factors for severe oral mucositis following autologous SCT; all doses were administered over 1-day. Parallel to this study, Palumbo, et al found a greater incidence of non-hematologic toxicities in patients who received higher doses of melphalan although this study evaluated melphalan 200 mg/m2 versus 100 mg/m2; all doses were administered over 1-day. Along with toxicity profile, it is unknown whether administering melphalan over 1-day versus 2-days will affect response rates post-transplantation and progression-free survival of patients. We propose a retrospective comparison between patients who have received 1-day melphalan versus 2-day melphalan to evaluate these outcomes. A retrospective chart review of all patients with MM receiving high dose melphalan for autologous SCT from January 2010-October 2012 will be conducted. Inclusion criteria:1All patients with primary diagnosis of MM undergoing autologous SCT2Conditioning regimen consisting of melphalan 200 mg/m2318 years of age and older Exclusion criteria:1Patients who received reduced dose melphalan, 140 mg/m2, as conditioning regimen2For patients who received tandem autologous SCT, only the first SCT will be evaluated Preliminary results to be presented.

A prenotification letter increased initial response, whereas sender did not affect response rates

ObjectiveTo find ways to improve response rates of medical and health surveys. We investigated whether a prenotification letter instead of a second reminder and varying senders of the questionnaires would affect response rates. Study Design and SettingWe present the results of two studies. In the first study, four groups were compared that either received a prenotification letter (group 1 and 2) or a second reminder letter (group 3 and 4); received the questionnaire from either a research institute (group 1 and 3) or a health insurance company (HIC; group 2 and 4). In the second study, we compared two groups that received the questionnaire sent by either a HIC or a hospital. Response rates, response speed, respondent characteristics, item nonresponse, and mean scores on quality aspects and global ratings were compared. ResultsResponse rates did not differ significantly between groups. Prenotification groups returned their questionnaires faster. No other significant differences were found for response speed, respondent characteristics, item nonresponse, or mean scores. ConclusionA prenotification letter does only increase initial response speed and does not increase total response rates. A prenotification letter should be considered when quick response is desirable. Varying senders had no effect on response rates.

Combining Mail and E-Mail Contacts to Facilitate Participation in Mixed-Mode Surveys

This study examines how available e-mail addresses can be incorporated into mixed-mode procedures for surveys of the public, especially client groups. Cooperative Extension Service clients provide the basis for analyzing how implementation procedures affect response rates and substantive findings. These clients form three strata based on contact information provided: postal address only, e-mail only, and both. From clients who provided mail and e-mail addresses, four experimental groups were created, including two mixed-mode groups, a mail-only group and an e-mail-only group. Using mail and e-mail addresses to implement a sequence of e-mail and postal invitations in a mixed-mode design resulted in response rates that are equivalent to those for mail-only surveys. Also, clients who provided a postal address only differed on some attributes from those in the other strata. This study demonstrates the benefit of obtaining e-mail addresses and using them in mixed-mode surveys.

The Use and Effects of Incentives in Surveys

This article is intended to supplement rather than replace earlier reviews of research on survey incentives, especially those by Singer (2002); Singer and Kulka (2002); and Cantor, O’Hare, and O’Connor (2008). It is based on a systematic review of articles appearing since 2002 in major journals, supplemented by searches of the Proceedings of the American Statistical Association’s Section on Survey Methodology for unpublished papers. The article begins by drawing on responses to open-ended questions about why people are willing to participate in a hypothetical survey. It then lays out the theoretical justification for using monetary incentives and the conditions under which they are hypothesized to be particularly effective. Finally, it summarizes research on how incentives affect response rates in cross-sectional and longitudinal studies and, to the extent information is available, how they affect response quality, nonresponse error, and cost-effectiveness. A special section on incentives in Web surveys is included.

Real Response to Therapy in Chronic Hepatitis C Virus Patients: A Study From Iran

BackgroundDespite significant advances in the treatment of chronic hepatitis C in the past decades, factors which can affect response rates to combination therapy; peginterferon and ribavirin, are still under study and reaching sustained virological response (SVR) is affected by several different factors.ObjectivesTo investigate predictor factors contributing to SVR in Iranian patients.Patients and MethodsThe present non-randomized, clinical trial was conducted on 100 patients referred to the Tehran Hepatitis Center in 2009-2011. The patients were administered combined peginterferon α-2a-ribavirin treatment, based on the standard protocol of the Iranian Ministry of Health. At the end of the treatment, the SVR rate and predictors were evaluated.ResultsThe mean age of the patients was 42 and 78% were male. Genotype 1a was the most common (70%) and 55% of patients were treatment naïve. The outcomes showed that 12%, 16% and 22% patients were; non-responders, breakthroughs and relapsers, respectively, while 50% of the patients reached SVR. Patients reaching SVR were aged 40 years or lower, they were less likely to have been a non-responder in prior treatments, more likely to have a non-1a genotype and a higher number had an HCV RNA of less than 600 000 IU/ml. The multivariate analysis showed that an age of 40 or lower (OR = 3.74, CI95% = 1.52-9.22), a non-1a genotype (OR = 3.71, CI 95% = 1.40-9.81) and an HCV RNA less than 600 000 IU/ml (OR = 2.52, CI 95% = 1.03-6.15) may be useful SVR predictors.ConclusionsThe findings of the present study showed that half of the patients reached SVR through combined peginterferon α-2a and ribavirin treatment, the majority of whom had genotype 3a and a minority had genotype 1a. In addition, an age of 40 or lower, non-1a genotype and a viral load less than 600 000 IU/ml were strong SVR predictors.

Effects of altering motivation for food in rats trained with food reinforcement to discriminate between d-amphetamine and saline injections

Previous studies have shown that altering motivation typically affects stimulus generalization in animals trained to discriminate exteroceptive stimuli, but few studies have evaluated the effects of manipulating motivation on drug stimuli. In the few published studies, motivation levels were manipulated by arranging different feeding conditions prior to stimulus generalization tests with rats trained to discriminate morphine from vehicle and in pigeons trained to discriminate phencyclidine or pentobarbital from vehicle. In the present study, rats maintained at 80% of free-feeding weights were trained to discriminate between injections of 1.0mg/kg d-amphetamine and saline in a two-lever food-reinforced operant procedure. Generalization tests were then conducted with a range of d-amphetamine doses (0, 0.03, 0.1, and 0.3, 1.0mg/kg) when the rats were not fed before experimental sessions (high motivation) and when they were pre-fed 1g of food (moderate motivation) or their daily ration of food (low motivation) 1h before test sessions. Changing the motivation level significantly affected response rate and latency to the first response in generalizations tests, but did not significantly affect mean percentage of drug-appropriate responding (a continuous measure) or percentage of animals that selected the drug-appropriate lever (a quantal measure). The present findings indicate that manipulating motivation for food minimally impacts d-amphetamine discrimination, however, the range of conditions used to examine the effects of motivating operations on stimulus control by d-amphetamine drugs and other drugs is limited and the topic may warrant further investigation.

Factors affecting response rates to mailed preoperative surveys among arthroplasty patients

To identify factors that affect patient response rates to preoperative functional surveys in hip and knee arthroplasty patients. From May 2008 to March 2009, 247 patients were scheduled more than 4 wk in advance for hip or knee arthroplasty by one of two participating surgeons at our center. A personalized questionnaire comprised of the Short Form 12 (SF-12) and Western Ontario and McMaster Universities (WOMAC) Index was mailed to patients at random time points ranging from 7 to 101 d prior to surgery. Nine independent factors were documented prospectively, including age, gender, ethnicity, marital status, type of surgery, surgeon, days prior to surgery (DPS) of survey mailing, WOMAC score and SF-12 score. The date of the completed survey receipt was also documented. For non-responders, the surveys were completed with the research team at the hospital upon admission. Multivariate regression and χ(2) analysis were performed with Statistical Analysis Software software. DPS was the only factor that affected patient response. Mailing surveys 26 d to 31 d prior to surgery dates led to a peak response rate of 80% that was significantly higher (P < 0.023) than response rates for patients who were mailed their surveys ≤ 16 d (62.5%), 17 d to 25 d (70%) or ≥ 32 d prior to surgery (55%). No other factors, including preoperative WOMAC and SF-12 scores, significantly influenced response behavior. The DPS was independently the most significant predictor of response rates for pre-operative functional data among patients scheduled for hip and knee arthroplasty.

Effect of stamped reply envelopes and timing of newsletter delivery on response rates of mail survey: a randomised controlled trial in a prospective cohort study

ObjectiveTo examine the effects of stamped reply envelope and the timing of newsletter distribution.DesignA randomised controlled trial in a prospective cohort study with a 2×2 factorial design of two interventions.SettingThe...

Social anxiety in the general population: Introducing abbreviated versions of SIAS and SPS

Social anxiety is characterized by the experience of stress, discomfort and fear in social situations, and is associated with substantial personal and societal burden. Two questionnaires exist that assess the aspects of social anxiety, i.e. social interaction anxiety (SIAS) and social phobia (SPS). There is no agreement in literature on the dimensionality of social anxiety. Further, the length of a questionnaire may negatively affect response rates and participation at follow-up occasions. To explore the structure of social anxiety in the general population, and to examine psychosocial and sociodemographic correlates. Our second aim was to construct abbreviated versions of SIAS and SPS that can be easily used and with minimal burden. A total of 1598 adults from the general Dutch population completed a survey asking information on social anxiety, mood and demographics. Exploratory and confirmatory factor analyses as well as reliability analysis with item-total statistics were performed. Confirmatory factor analysis revealed a 3-factor structure for social phobia, and a 2-factor structure for the SIAS, with the second factor containing both reversely scored items. The abbreviated versions of SPS (11 items) and SIAS (10 items) show excellent discriminant and construct validity (Cronbach's α=.90 and .92), while specificity analysis showed that gender, marital status and educational level (SIAS(10): p<.0005; SPS(11): p<.0005) are important determinants of social anxiety. In the general population, social interaction anxiety and social phobia are two aspects of a higher-order factor of social anxiety. Social anxiety is validly captured by the short versions of SPS and SIAS, reducing the questionnaire burden for participants in epidemiological and biobehavioral research.

Deconstructing Pediatric Depression Trials: An Analysis of the Effects of Expectancy and Therapeutic Contact

This study investigated how study type, mean patient age, and amount of contact with research staff affected response rates to medication and placebo in acute antidepressant trials for pediatric depression. Data were extracted from nine open, four active comparator, and 18 placebo-controlled studies of antidepressants for children and adolescents with depressive disorders. A multilevel meta-analysis examined how study characteristics affected response rates to antidepressants and placebo. The primary finding was a main effect of study type across patient age and contact amount, such that the odds of medication response were greater in open versus placebo-controlled studies (odds ratio 1.87, 95% confidence interval 1.17-2.99, p = .012) and comparator studies (odds ratio 2.01, 95% confidence interval 1.16-3.48, p = .015) but were not significantly different between comparator and placebo-controlled studies. No significant main effects of patient age or amount of contact with research staff were found for analyses of response rates to medication and placebo. Response to placebo in placebo-controlled trials did significantly increase with the amount of therapeutic contact in older patients (age by contact; odds ratio 1.08, 95% confidence interval 1.01-1.15, p = .038). Although patient expectancy strongly influences response rates to medication and placebo in depressed adults, it appears to be less important in the treatment of children and adolescents with depression. Attempts to limit placebo response and improve the efficiency of antidepressant trials for pediatric depression should focus on other causes of placebo response apart from expectancy.

Bouts, Changeovers, and Units of Operant Behavior

Responding of various types occurs as bouts of activity separated by pauses. Deprivation and reinforcement affect the tendency to initiate and persist engaging in bouts but have little effect on performance once engaged. Such a two-state conception encourages time-based measurement even when the response is recorded as a brief, discrete event like a lever press. The two-state conception also emphasizes that response rate, as commonly calculated, is a mixture of different units controlled by different sets of variables. Focusing on the components of the two states--especially bout-initiations (or changeovers)--might help solve some puzzles presented by total response-rate data and might help clarify how schedules of reinforcement affect response rate.

A controlled trial of envelope colour for increasing response rates in older women

Postal questionnaires are widely used in health research to provide measurable outcomes in areas such as quality of life. Participants who fail to return postal questionnaires can introduce non-response bias. Previous studies within populations over the age of 65 years have shown that response rates amongst older people can be 60% or less. The current study sought to investigate whether envelope colour affected response rates in a study about the effectiveness of screening older women for osteoporosis. A total of 2803 eligible female participants aged between 70 and 85 were sent an invitation pack from their GP practice. The invitation was either in a brown or white envelope and contained a matching pre-paid reply envelope. A study questionnaire was also sent out in brown or white envelopes 1 week after consenting to participate in the trial. The overall response rate was 78%. There was little evidence of an effect of envelope colour on response to the invitation to participate in the trial (OR 1.04, 95% CI 0.87-1.24). Similarly, there was no influence of envelope colour on the number of participants returning their questionnaires (OR 0.99, 95% CI 0.60-1.63). There was weak evidence of an effect of envelope colour on the response rates of the consent process (OR 0.86, 95% CI 0.74-1.00). When we updated a recent meta-analysis with the results of this study, there was a non-statistically- significant trend for greater response rates with brown envelopes compared with white envelopes (OR 1.19, 95% CI 0.86-1.64, I2=92%). However, the results where influenced by one study and when this study was excluded the pooled estimate was 0.98 (95% CI 0.89-1.08, I2=0%). This study found no evidence to suggest envelope colour has an effect on response to participate in a trial or questionnaire returns. There is weak evidence to suggest envelope colour may affect consent into a trial.

Using different approaches to conducting postal questionnaires affected response rates and cost-efficiency

ObjectiveTo compare three different approaches for consent in postal questionnaire in terms of response rate, time consumption, and cost-efficiency, and to collect a demographic questionnaire for dropout analyses. Study Design and SettingPopulation survey in Sweden. Mothers and fathers (n=600) of three hundred 3-year olds were divided into three groups. One group was asked to Actively Agree to participate in a cover letter and send consent back to receive the main questionnaire. The second group received the cover letter, the consent, and the main questionnaire in the initial mailings, Direct Delivery. The third group received the cover letter and consent form in which they were asked to Actively Decline participation within 7 days if they did not want to participate. Otherwise, they were sent the main questionnaire. All parents were asked to fill in a demographic questionnaire regardless of whether they wanted to complete the main questionnaire. ResultsThe highest response rate was in the Actively Decline mode. The cost-efficiency for this approach was 1.52 compared with Direct Delivery and 1.29 compared with Actively Agree. ConclusionResearchers can improve the response rate, time consumption, and cost-efficiency and obtain a demographic questionnaire for dropout analysis by using the Actively Decline approach for postal questionnaires.

Predicting response to incretin-based therapy

There are two important incretin hormones, glucose-dependent insulin tropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). The biological activities of GLP-1 include stimulation of glucose-dependent insulin secretion and insulin biosynthesis, inhibition of glucagon secretion and gastric emptying, and inhibition of food intake. GLP-1 appears to have a number of additional effects in the gastrointestinal tract and central nervous system. Incretin based therapy includes GLP-1 receptor agonists like human GLP-1 analogs (liraglutide) and exendin-4 based molecules (exenatide), as well as DPP-4 inhibitors like sitagliptin, vilda- gliptin and saxagliptin. Most of the published studies showed a significant reduction in HbA 1c using these drugs. A critical analysis of reported data shows that the response rate in terms of target achievers of these drugs is average. One of the first actions identified for GLP-1 was the glucose-dependent stimulation of insulin secretion from islet cell lines. Following the detection of GLP-1 receptors on islet beta cells, a large body of evidence has accumulated illustrating that GLP-1 exerts multiple actions on various signaling pathways and gene products in the β cell. GLP-1 controls glucose homeostasis through well-defined actions on the islet β cell via stimulation of insulin secretion and preservation and expansion of β cell mass. In summary, there are several factors determining the response rate to incretin therapy. Currently minimal clinical data is available to make a conclusion. Key factors appear to be duration of diabetes, obesity, presence of autonomic neuropathy, resting energy expenditure, plasma glucagon levels and plasma free fatty acid levels. More clinical evidence is required to identify the factors affecting response rate to incretin therapy.

Effect of Stimulus Type on the Eye Movements of Children

The authors investigated whether pictures elicit superior response rates and eye movement dynamics on saccade and pursuit tasks than do dots or spots of light and whether the need for more interesting stimuli is age dependent. Using video eye tracking, horizontal eye movements were investigated in children and adults using dots and small colored pictures as stimuli. Saccade data were obtained from 61 people and pursuit data from 53 people, ages 3 to 30 years, with no known ocular, ocular motor, neurologic, or systemic disease. Saccadic stimuli were randomly presented in steps ranging in size from 5° to 30°. Pursuits at four velocities (5°/s, 10°/s, 20°/s, and 30°/s) were tested using step ramp stimuli. Picture targets result in age-dependent improvements in ocular motor responses compared with dots. With the exception of saccadic accuracy, the youngest children are most affected by the type of target. Adults are affected very little. For pictures, saccadic response rates (t((60)) = 4.30, P < 0.001), saccadic peak velocities (t((60)) = 2.24, P = 0.03), saccadic accuracy (t((59)) = 2.34, P = 0.02), and closed-loop pursuit gains (F((3,50)) = 2.86, P = 0.046) are higher. Saccadic error rates (t((60)) = 3.91, P < 0.001) and saccadic latencies (t((59)) = 9.5, P < 0.001) are lower with pictures. Stimulus characteristics can affect response rates and eye movement dynamics, particularly in young children. To avoid underestimation of eye movement performance in young children, it is important to use meaningful targets. Furthermore, when comparing the ocular motor performance of children across studies one must consider the type of stimuli used.

Designing surveys for radiography and radiation therapy

AbstractSurveys using standardised questionnaires are frequently used in the health area for research, to gather information to inform or improve clinical practice and to gage perceptions or attitudes towards particular issues. As we begin to conduct more studies in the areas of radiography and radiation therapy we need to ensure that it is essential that we use reliable and valid research methods so that findings are robust and, importantly, useable in clinical practice. This review focuses on how to design the questionnaire and highlights some key rules to help avoid the many pitfalls in survey design. The importance of the planning stage and time spent reviewing and revising questions is emphasised and the benefits and challenges of using existing instruments are discussed. Questionnaire layout is addressed and also the wording of individual questions as both of these will affect response rates and how people interpret questions. Wording can be difficult and may take a few drafts to get right. Several examples are given to demonstrate the concepts. The key messages in this review are: spend time planning and make the questionnaire brief, easy and safe. Issues such as response rates, types of questions, how to test for reliability and validity; and how to analyse the data will be covered in a further review for The Radiographer.

Safety and efficacy of Gamma Knife surgery for brain metastases in eloquent locations

Object Brain metastases are the most frequently occurring cerebral tumors. Tumors that are located in eloquent cerebral parenchyma can cause considerable morbidity and may pose a significant challenge during surgery. Gamma Knife surgery (GKS) is a recognized treatment modality for brain metastases. This study was undertaken to assess the safety and efficacy of GKS, specifically for brain metastases in eloquent locations. Methods Charts of patients harboring brain metastases that were treated by GKS at the Centre Hospitalier Universitaire de Sherbrooke between August 2004 and April 2008 were reviewed. Planning images were assessed by an independent neurosurgeon to assess tumor location. Eloquent locations included the primary motor, somatosensory, speech, and visual cortices; the basal ganglia; the thalamus; and the brainstem. Data on survival, tumor response, and complications were analyzed and compared with data published on surgical treatment of these lesions. Results During the study period, 650 metastases in 295 patients were treated with GKS; of these, 164 metastases in 95 patients were located in eloquent areas. In this subgroup, the median age of patients was 59 years and women constituted 57.9% of the population. The median Karnofsky Performance Scale score was 80% (range 50%–100%). Patients were categorized according to their recursive partitioning analysis class: Class 1, 22.1%; Class 2, 70.5%; and Class 3, 7.4% of patients. Non–small cell lung cancer was the most common primary tumor (63.2% of metastases), followed by small cell lung (8.4%), breast (7.4%), colorectal (5.3%), and renal cell (4.2%) cancers, as well as melanoma (4.2%). The median dose to the tumor margin was 18 Gy (range 14–24 Gy). The median duration of survival after GKS was 8.2 months. The recursive partitioning analysis class was the most significant variable affecting survival (p &lt; 0.0001). Immediate control was achieved in 92.9% of tumors, and 68.6% of tumors were still controlled at the last follow-up. The median time to tumor progression was 16 months. Higher margin dose (p = 0.002), the absence of edema (p = 0.009), and the non–small cell lung cancer tissue type (p = 0.035) positively affected response rates. Steroid medications were no longer used in 46% of patients after GKS. New neurological deficits occurred in 5.7% of patients and seizures in 5.7%. All these deficits were transient and patients completely recovered in response to a temporary course of steroids. Imaging studies showed that new edema occurred in 8.6% of treated metastases and biopsy-proven radiation necrosis in 1.4%. Conclusions Gamma Knife surgery is safe and effective for brain metastases located in eloquent areas.

Management of Bleeding In Acquired Hemophilia: Results of the European Acquired Hemophilia Registry (EACH2)

AbstractAbstract 716 Objective.Acquired hemophilia (AH) is a hemorrhagic syndrome, caused by autoantibodies inhibiting coagulation FVIII. The optimal hemostatic therapy is not clear. This analysis aimed to describe the first-line management of bleeding in AH within Europe. Methods.Data from the EACH2 registry, a multicentre, international, web-based registry, were used to analyze the use of recombinant activated factor VII (rFVIIa), activated prothrombin complex concentrates (APCC), FVIII concentrates, and DDAVP as first line hemostatic therapy. There was no predefined treatment protocol, each center was free to follow local clinical practice. Response rate is the number of bleeds resolved as judged by each investigator. Data on demographics, pregnancy and immunosuppression will be presented in other abstracts. Data are given as medians and interquartile ranges (IQR) or odds ratios (OR) and 95% confidence intervals (CI). Results.Data of 501 patients (pts) (235 male, 266 female, median age 74 years (range 14–104)) were prospectively collected between 2003 and 2009 in 90 centers of 11 European countries. In 474 pts at least one bleeding episode is reported; 159 pts had 2 episodes (the second bleeding episode a median 26 (13/67) days after the first), 51 pts had 3 episodes, 16 pts. more than 3 bleedings. Of the 474 initial bleeding episodes, 70.3% were reported as severe (criteria prospectively defined), 50.2% had deep musculoskeletal or retroperitoneal bleeding, 53.2% skin hematomas, 31.6% mucosal bleeding, and only 4.9% hemarthroses. In 77.4% the bleedings occurred spontaneous, 8.4% after trauma, 8.2% after surgery. Median FVIII activity at the time of bleeding was 0.02 U/mL (0.01/0.05 U/mL), the inhibitor titer 19 BU/mL (5.5/64 BU/mL). There was no significant association between FVIII activity or inhibitor titer and severity of bleeding. Hemostatic therapy was given in 70.5% of the bleedings. First line therapy is presented in the table:Table:First line hemostatic therapySubstancen (%)initial dosedurationtotal doserFVIIa170 (50.9%)90 (85/103) mcg/kg4 (2/10) days90 (25/235) mgAPCC64 (19.2%)67 (54/81) U/kg5 (2/10) days30 (12/57) × 1000 UFVIII conc.60 (18%)50 (40/76) U/kg4 (1/6) days20 (9/50) × 1000 UDesmopressin was given in 6%, antifibrinolytic drugs in 18%, and high dose immunoglobulin infusions in 11.1%; immunoadsorption was performed in 5.4%, plasmapheresis in 0.6%. Overall bleeding resolved in 76.4%, in median after 4 days (IQR 2–10 days). Second line therapy with an alternative substance was applied in 23.6% (in 17.4% because bleeding did not resolve). The use of bypassing agents (rFVIIa or APCC) resulted in a significant higher rate of bleeding control (91.2 %) than the use of FVIII or desmopressin (71.0 %) (p<0.001), there was no difference between rFVIIa (90.9 %) and APCC (94.3 %). To minimize bias, propensity score matched data analysis (1) based on age, gender, FVIII level, inhibitor titre, hemoglobin level, site, severity and cause of bleeding was carried out. It confirmed that first line treatment with a bypassing agent resulting in a better control of bleeding compared to FVIII or desmopressin (OR 0.25, 95% CI 0.12–0.53; p=0.004). There was no difference in efficacy between rFVIIa and APCC (OR 1.0, 95%CI 0.24–4.18). No other patient- or disease-related parameters affected response rate. Deaths due to bleeding occurred in 3% of the patients, only few serious adverse events were recorded: 1.4% myocardial infarction, 0.2% stroke, 1.0% venous thromboembolic events. There was no significant association of death or severe adverse events with a specific hemostatic therapy. Conclusion.Bypassing agents are the preferred first line hemostatic therapy in AH (70.1% of the episodes) and have a significantly better efficacy than FVIII or DDAVP; rFVIIa was the agent preferred by most clinicians (~50%), rFVIIa and APCC were equally efficacious. Treatment with bypassing agents was safe and highly effective in controlling bleeding in AH.1. D'Agostino RB Jr: Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 1998; 17:2265–2281. Disclosures:Knoebl:Novo Nordisk: Consultancy, Membership on an entity's Board of Directors or advisory committees, NovoNordisk fund the EACH2 registry, Research Funding; Baxter Healthcare: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding. Baudo:NovoNordisk: Consultancy, Honoraria, NovoNordisk fund the EACH2 registry, Speakers Bureau; Bayer Healthcare: Honoraria, Speakers Bureau. Collins:NovoNordisk: Consultancy, Honoraria, The EACH2 registry was funded by Novonordisk; Baxter Healthcare: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau. Huth-Kuehne:NovoNordisk: Consultancy, Membership on an entity's Board of Directors or advisory committees, NovoNordisk fund the EACH2 registry; Baxter Healthcare: Consultancy, Membership on an entity's Board of Directors or advisory committees. Levesque:NovoNordisk: NovoNordisk fund the EACH2 registry. Marco:Novo Nordisk: Novonordisk fund the EACH2 registry. Nemes:Novo Nordisk: Novonordisk fund the EACH2 registry. Pellegrini:Novonordisk: Consultancy, Honoraria, Speakers Bureau, The EACH2 registry is funded by Novonordisk. Tengborn:Novo Nordisk: Novonordisk fund the EACH2 registry.