Chapter 2 42 Materials and Methods Design of the survey and participants This survey study was performed and reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).18 As this study did not apply the Medical Research Involving Human Subjects Act (WMO), approval by the ethics committee was not required. The survey was written in Dutch, consisted of 21 questions, and was created using a web-based program called Survio.19 The closed-survey (i.e., only accessible through invitation) was sent by email to all members of the Dutch Working Group Coloproctology as well as to gastrointestinal surgeons, fellows, and residents of each hospital in the Netherlands. We used the email database of our previous survey among Dutch gastrointestinal surgeons concerning the management of anal fistulas.20 Known invalid domains were removed and the list was checked globally by contact information that was retrieved from the Dutch Association of Surgery. The survey was accompanied by an invitation email explaining the objectives of the study and length of time of the survey (<10 min). One reminder email was sent after 4 days, the second after 10 weeks. No time limit was set for filling in the survey. The survey was available online from June 25th, 2021, to September 30th, 2021. Survey The survey consisted of 3 pages and a total of 21 questions, formulated by all five authors. The questions were reviewed by two colorectal surgeons and one urologist, after which the survey was edited. All authors conducted a pilot for testing validity. The survey consisted of topics concerning baseline characteristics such as respondents’ function, type of hospital, years of experience in treating CAF and number of surgical procedures – including botulinum toxin injections – per year. Other questions assessed medical history and physical examination with attention to pelvic floor complaints and dysfunctions; diagnostics techniques; surgical approaches; follow-up and presumed effect of treatment. Seventeen questions were single-choice, two were multiple-choice and two questions required a number. The participants were given the chance to review and change their answers. The survey was tested for completeness, usability, and technical functionality before submission. The survey was voluntary, and no incentives were offered.
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