{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T16:30:49Z","timestamp":1789576249726,"version":"build-2803163510"},"reference-count":25,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T00:00:00Z","timestamp":1600387200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JND"],"published-print":{"date-parts":[[2020,9,18]]},"abstract":"<jats:p>Background: Natural history data are essential for trial design in Duchenne (DMD) and Becker muscular dystrophy (BMD), but recruitment for observational studies can be challenging. Objective: We reviewed reasons why patients or caregivers declined participation, and compared characteristics of participants and non-participants to assess possible selection bias in four observational studies, three on DMD and one on BMD. Methods: Three pediatric DMD studies focused on cross-sectional cognitive function and brain MRI (DMDbrain, n\u200a=\u200a35 and DMDperfusion, n\u200a=\u200a12), and on longitudinal upper extremity function and muscle MRI (DMDarm, n\u200a=\u200a22). One adult BMD study assessed longitudinal functioning (n\u200a=\u200a36). Considerations for non-participation were retrospectively reviewed from screening logs. Age, travel-time, DMD gene mutations and age at loss of ambulation (DMDarm and BMD study only), of participants and non-participants were derived from the Dutch Dystrophinopathy Database and compared using nonparametric tests (p\u200a&lt;\u200a0.05). Results: The perceived burden of the protocol (38.2%), use of MRI (30.4%), and travel-time to the study site (19.1%) were the most frequently reported considerations for non-participation. Only few patients reported lack of personal gain (0.0\u2013 5.9%). Overall, participating patients were representative for the studied sub-populations, except for a younger age of DMDarm study participants and a complete lack of participants with a mutation beyond exon 63. Conclusion: Optimizing patient involvement in protocol design, improving MRI experiences, and integrating research into clinics are important factors to decrease burden and facilitate participation. Nationwide registries are essential to compare participants and non-participants and ensure representative observational research. Specific effort is needed to include patients with distal mutations in cognitive studies.<\/jats:p>","DOI":"10.3233\/jnd-200541","type":"journal-article","created":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T10:54:52Z","timestamp":1599562492000},"page":"433-442","source":"Crossref","is-referenced-by-count":13,"title":["Decision-Making And Selection Bias in Four Observational Studies on Duchenne and Becker Muscular Dystrophy"],"prefix":"10.1177","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5022-3745","authenticated-orcid":false,"given":"Karin J.","family":"Naarding","sequence":"first","affiliation":[{"name":"Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands"},{"name":"Duchenne Center Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2932-4327","authenticated-orcid":false,"given":"Nathalie","family":"Doorenweerd","sequence":"additional","affiliation":[{"name":"C.J. Gorter Center for High Field MRI, Department of Radiology, LUMC, Leiden, Netherlands"},{"name":"John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Za\u00efda","family":"Koeks","sequence":"additional","affiliation":[{"name":"Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2870-5841","authenticated-orcid":false,"given":"Ruben G.F.","family":"Hendriksen","sequence":"additional","affiliation":[{"name":"C.J. Gorter Center for High Field MRI, Department of Radiology, LUMC, Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kinita A.","family":"Chotkan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne D.","family":"Krom","sequence":"additional","affiliation":[{"name":"Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands"},{"name":"Duchenne Center Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1634-1427","authenticated-orcid":false,"given":"Imelda J.M.","family":"de Groot","sequence":"additional","affiliation":[{"name":"Duchenne Center Netherlands"},{"name":"Department of Rehabilitation, Radboud University Medical Center, Nijmegen, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara S.","family":"Straathof","sequence":"additional","affiliation":[{"name":"Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5892-5143","authenticated-orcid":false,"given":"Erik H.","family":"Niks","sequence":"additional","affiliation":[{"name":"Department of Neurology, Leiden University Medical Center (LUMC), Leiden, Netherlands"},{"name":"Duchenne Center Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5772-7177","authenticated-orcid":false,"given":"Hermien E.","family":"Kan","sequence":"additional","affiliation":[{"name":"Duchenne Center Netherlands"},{"name":"C.J. 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