Does telling people what they have been doing change what they do? A systematic review of the effects of audit and feedback
Does telling people what they have been doing change what they do? A systematic review of the effects of audit and feedback
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DOI：
10.1136/qshc.2006.018549
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发表时间：
2006-12-01
影响因子：
--
通讯作者：
Oxman, Andrew D.
中科院分区：
文献类型：
--
作者：
Jamtvedt, Gro;Young, Jane M.;Oxman, Andrew D.
背景：许多人提倡审计和反馈作为一种改善专业实践的策略。更新的科克伦审查的审计和反馈的影响的主要结果reported.Data sources：科克伦有效的实践和组织的护理组的注册到2004年1月进行了搜索。随机试验的审计和反馈，报告客观衡量的专业实践在医疗环境或医疗成果included.Review方法：数据独立提取和研究质量进行了评估，由两名审查员。主要结果：共纳入118个试验。在主要分析中，纳入了来自72项研究的88项比较，比较了审计和反馈作为组成部分的任何干预与无干预。对于二分结局，符合预期实践的中位调整风险差异为5%（四分位数间距3-11）。对于连续性结局，相对于对照组的中位数调整百分比变化为16%（四分位数间距5-37）。低基线符合推荐的做法和更高的强度的审计和反馈出现预测审计和feedbacks.Conclusions的有效性：审计和反馈可以有效地提高专业实践。影响一般是小到中等。当对建议做法的基线遵守程度较低而审计和反馈的强度较高时，审计和反馈的绝对效果可能较大。
Background: Many people advocate audit and feedback as a strategy for improving professional practice. The main results of an update of a Cochrane review on the effects of audit and feedback are reported.Data sources: The Cochrane Effective Practice and Organisation of Care Group's register up to January 2004 was searched. Randomised trials of audit and feedback that reported objectively measured professional practice in a healthcare setting or healthcare outcomes were included.Review methods: Data were independently extracted and the quality of studies were assessed by two reviewers. Quantitative, visual and qualitative analyses were undertaken.Main results: 118 trials are included in the review. In the primary analysis, 88 comparisons from 72 studies were included that compared any intervention in which audit and feedback was a component to no intervention. For dichotomous outcomes, the median-adjusted risk difference of compliance with desired practice was 5% (interquartile range 3-11). For continuous outcomes, the median-adjusted percentage change relative to control was 16% (interquartile range 5-37). Low baseline compliance with recommended practice and higher intensity of audit and feedback appeared to predict the effectiveness of audit and feedback.Conclusions: Audit and feedback can be effective in improving professional practice. The effects are generally small to moderate. The absolute effects of audit and feedback are likely to be larger when baseline adherence to recommended practice is low and intensity of audit and feedback is high.