Concerns Regarding Sampling Methodology in “Acceptance, Awareness, Attitude, and Practices Toward Heart Transplantation: A Saudi Based Survey”

Dear Editor of the Journal of Saudi Heart Association,

I am writing to express my concerns regarding the sampling methodology employed in the recent article by Walid Abukhudair et al., titled “Acceptance, Awareness, Attitude, and Practices Toward Heart Transplantation: A Saudi Based Survey” [1]. While the study presents valuable insights into the perceptions and attitudes toward heart donation in Saudi Arabia, the reliance on internet-based surveys for data collection raises significant methodological concerns that may impact the validity and generalizability of the findings.

Firstly, the use of an Internet survey inherently limits the participant pool to individuals with Internet access and proficiency, potentially excluding segments of the population who are either not technologically savvy or lack consistent access to the Internet. This limitation is particularly pertinent given the demographic profile of Saudi Arabia, where differences in internet usage across various age groups, educational levels, and socioeconomic statuses are pronounced. As such, the findings may not accurately represent the attitudes and practices of the entire Saudi population, especially those in rural areas or of lower socio-economic status, who are less likely to participate in online surveys.

Secondly, the recruitment of participants through email and social media channels introduces an element of self-selection bias. Individuals who are active on these platforms and choose to respond to the survey are likely to have distinct characteristics or interests compared to those who do not engage with these mediums. This self-selection could skew the data towards certain attitudes or levels of awareness about heart donation that may not be reflective of the broader population.

Furthermore, the reliance on digital platforms for data dissemination could also influence the respondents' attitudes and knowledge levels. The proliferation of information, and sometimes misinformation, on social media about medical topics could have preconditioned the respondents' perceptions and understanding of heart donation and transplantation, leading to biased responses.

It is crucial for future research in this area to adopt more inclusive sampling methods that can capture a wider and more representative demographic. Strategies such as stratified random sampling, face-to-face interviews, and the use of traditional media channels for recruitment could be employed to mitigate the limitations of internet-based surveys. These approaches would help ensure that the perspectives of underrepresented groups are adequately captured, thereby enhancing the robustness and applicability of the research findings.

In conclusion, while the study by Walid Abukhudair et al. contributes important insights into the current state of awareness and attitudes towards heart transplantation in Saudi Arabia, the methodological limitations associated with internet-based sampling warrant cautious interpretation of the results. Future research should aim to incorporate more diverse and representative sampling methods to better inform policy and practice in the realm of organ donation and transplantation.