Mugford M, Banfield P, O'Hanlon M
National Perinatal Epidemiology Unit, Radcliffe Infirmary, Oxford.
BMJ. 1991 Aug 17;303(6799):398-402. doi: 10.1136/bmj.303.6799.398.
To establish what is known about the role of feedback of statistical information in changing clinical practice.
Review of 36 studies of interventions entailing the use of statistical information for audit or practice review, which used a formal research design.
Papers identified from computer searches of medical and health service management publications, of which 36 describing studies of interventions designed to influence clinical care and including information feedback from clinical or administrative data systems were reviewed.
Evidence for effect of information feedback on change in clinical practice.
Information feedback was most likely to influence clinical practice if it was part of strategy to target decision makers who had already agreed to review their practice. A more direct effect was discernable if the information was presented close to the time of decision making. The questions of the optimum layout and quantity of information were not addressed; the 36 papers were insufficient for defining good formats for information to be used for audit or quality assurance.
Given the cost of information processing and the current emphasis on closing the audit loop in the health services, it is important that the use of information in the audit process should be critically evaluated.
确定关于统计信息反馈在改变临床实践中的作用的已知情况。
对36项涉及使用统计信息进行审核或实践评估的干预研究进行综述，这些研究采用了正式的研究设计。
从医学和卫生服务管理出版物的计算机检索中识别出的论文，其中36篇描述了旨在影响临床护理并包括来自临床或行政数据系统的信息反馈的干预研究，并进行了综述。
信息反馈对临床实践改变的影响证据。
如果信息反馈是针对已经同意审查其实践的决策者的策略的一部分，则最有可能影响临床实践。如果信息在决策时临近呈现，则可看出更直接的效果。未涉及信息的最佳布局和数量问题；这36篇论文不足以确定用于审核或质量保证的信息的良好格式。
鉴于信息处理的成本以及当前对卫生服务中闭合审核循环的重视，在审核过程中对信息的使用进行严格评估很重要。
