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PeerJ. 2017 Sep 12;5:e3785. doi: 10.7717/peerj.3785. eCollection 2017.

Factors influencing healthcare provider respondent fatigue answering a globally administered in-app survey.

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Department of Anesthesiology, Emory University, Atlanta, GA, United States of America.
Department of Anesthesiology, Children's Healthcare of Atlanta, Atlanta, GA, United States of America.



Respondent fatigue, also known as survey fatigue, is a common problem in the collection of survey data. Factors that are known to influence respondent fatigue include survey length, survey topic, question complexity, and open-ended question type. There is a great deal of interest in understanding the drivers of physician survey responsiveness due to the value of information received from these practitioners. With the recent explosion of mobile smartphone technology, it has been possible to obtain survey data from users of mobile applications (apps) on a question-by-question basis. The author obtained basic demographic survey data as well as survey data related to an anesthesiology-specific drug called sugammadex and leveraged nonresponse rates to examine factors that influenced respondent fatigue.


Primary data were collected between December 2015 and February 2017. Surveys and in-app analytics were collected from global users of a mobile anesthesia calculator app. Key independent variables were user country, healthcare provider role, rating of importance of the app to personal practice, length of time in practice, and frequency of app use. Key dependent variable was the metric of respondent fatigue.


Provider role and World Bank country income level were predictive of the rate of respondent fatigue for this in-app survey. Importance of the app to the provider and length of time in practice were moderately associated with fatigue. Frequency of app use was not associated. This study focused on a survey with a topic closely related to the subject area of the app. Respondent fatigue rates will likely change dramatically if the topic does not align closely.


Although apps may serve as powerful platforms for data collection, responses rates to in-app surveys may differ on the basis of important respondent characteristics. Studies should be carefully designed to mitigate fatigue as well as powered with the understanding of the respondent characteristics that may have higher rates of respondent fatigue.


Anesthesiology; In-app surveys; LMIC; Mobile applications; Respondent fatigue; Smartphones; Sugammadex; Survey design; Surveys; mHealth

Conflict of interest statement

No support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. The app was initially released in 2011 by Vikas O’Reilly-Shah with advertising in the free version and a paid companion app to remove the ads. The app intellectual property was transferred to Emory University in 2015 and advertisements were subsequently removed, and the companion app to remove ads made freely available for legacy users not updating to the ad-free version. Following review by the Emory University Research Conflict of Interest Committee, Vikas O’Reilly-Shah has been released from any conflict of interest management plan or oversight.

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