当前位置： SCI文献检索 > Cochrane Database of Systematic Reviews期刊下所有文献 > Audit and feedback: effects on professional practice and health care outcomes.

Audit and feedback: effects on professional practice and health care outcomes.

Abstract：

BACKGROUND:Audit and feedback has been identified as having the potential to change the practice of health care professionals. OBJECTIVES:To assess the effects of audit and feedback on the practice of health professionals and patient outcomes. SEARCH STRATEGY:We searched MEDLINE up to June 1997, the Research and Development Resource Base in Continuing Medical Education, and reference lists of related systematic reviews and articles. SELECTION CRITERIA:Randomised trials of audit and feedback (defined as any summary of clinical performance of health care over a specified period of time). The participants were health care professionals responsible for patient care. DATA COLLECTION AND ANALYSIS:Two reviewers independently extracted data and assessed study quality. MAIN RESULTS:Thirty-seven studies were included, involving more than 4977 physicians. The reporting of study methods was inadequate for almost all studies. In 31 out of 37 studies the randomisation process could not be determined. Information regarding data analysis was also lacking. For example, power calculations were not mentioned in 27 out of 37 studies. A variety of behaviours were targeted including the reduction of diagnostic test ordering, prescribing practices, preventive care, and the general management of a problem, for example hypertension. Twenty-eight studies measured physician performance, one study targeted patient outcomes in diabetes and the remaining eight studies measured both physician performance and patient outcomes. The relative percentage differences ranged from -16% to 152%. The clinical importance of the changes was not always clear. REVIEWER'S CONCLUSIONS:Audit and feedback can sometimes be effective in improving the practice of health care professionals, in particular prescribing and diagnostic test ordering. When it is effective, the effects appear to be small to moderate but potentially worthwhile. Those attempting to enhance professional behaviour should not rely solely on this approach.

journal_name

Cochrane Database Syst Rev

journal_title

The Cochrane database of systematic reviews

authors

Thomson O'Brien MA,Oxman AD,Davis DA,Haynes RB,Freemantle N,Harvey EL

doi

10.1002/14651858.CD000259

keywords:

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

CD000259

issue

issn

1469-493X

pii

CD000259

pub_type

杂志文章,评审

在线工具

Audit and feedback: effects on professional practice and health care outcomes.