Introduction: A commonly used method of obtaining information on patients' quality of life and wellbeing is through questionnaires. These are usually administered and analyzed by the home clinic including the physician responsible for the patient and his/her staff. This might increase the risk for bias due to the patient gratifications towards the physician and the staff, possibly leading to a false positive trend in the answers. To minimize this risk, a neutral third party could administer and analyze the study.
Methods: All patients treated with radical cystectomy and continent cutaneous urinary diversion (n=67) and orthotopic bladder substitution (n=52) for invasive bladder carcinoma were included. This study-base was randomized into 60 patients who were contacted by their home clinic at the Lund University Hospital and 59 patients who were contacted by a neutral third party at the Karolinska Institute in Stockholm. The core questionnaire QLQ-C30 and the bladder cancer specific module QLQ-BLM30 from EORTC were sent to all patients by mail.
Results: Response rates were high in both groups, 59 out of 60 in the "homeparty" - group and 56 out of 59 in the "third-party" - group. Concerning the results from QLQ-C30 there were statistically significantly more bowelproblems reported in the "third-party" - group than in the "home-party" - group (p<0.05). This difference was still significant after controlling for reconstructive method. There were no statistically significant differences between the groups in the QLQ-BLM30.
Conclusion: Though few factors differed between the two groups, the results could indicate that different results are obtained when a study is totally administered and analyzed by a neutral third party than by the "home" - clinic. Larger studies are needed to further clarify this hypothesis.