Department of Medical Informatics, Academic Medical Center, 1100 DD Amsterdam, The Netherlands.
Int J Med Inform. 2010 May;79(5):305-23. doi: 10.1016/j.ijmedinf.2010.01.011. Epub 2010 Feb 26.
To determine (1) how medical registries provide information feedback to health care professionals, (2) whether this feedback has any effect on the quality of care and (3) what the barriers and success factors are to the effectiveness of feedback.
Original articles in English found in MEDLINE Pubmed covering the period January 1990 to August 2007.
Titles and abstracts of 6223 original articles were independently screened by two reviewers to determine relevance for further review.
We used a standardized data abstraction form to collect information on the feedback initiatives and their effectiveness. The effect of the feedback was only described for analytic papers, i.e. papers that attempted to objectively quantify the effect on the quality of care and to relate this effect to feedback as an intervention. For analysis of the effectiveness, we categorized the initiatives based on the number of elements added to the feedback.
We included 53 papers, describing 50 feedback initiatives, of which 39 were part of a multifaceted approach. Our results confirm previous research findings that adding elements to a feedback strategy positively influences its effectiveness. We found 22 analytic studies, four of which found a positive effect on all outcome measures, eight found a mix of positive- and no effects and ten did not find any effects (neither positive nor negative). Of the 43 process of care measures evaluated in the analytic studies, 26 were positively affected by the feedback initiative. Of the 36 evaluated outcome of care measures, five were positively affected. The most frequently mentioned factors influencing the effectiveness of the feedback were: (trust in) quality of the data, motivation of the recipients, organizational factors and outcome expectancy of the feedback recipients.
The literature on methods and effects of information feedback by medical registries is heterogeneous, making it difficult to draw definite conclusions on its effectiveness. However, the positive effects cannot be discarded. Although our review confirms findings from previous studies that process of care measures are more positively influenced by feedback than outcome of care measures, further research should attempt to identify outcome of care measures that are sensitive to behaviour change as a result of feedback strategies. Furthermore, future studies evaluating the effectiveness of feedback should include a more extensive description of their intervention in order to increase the reproducibility of feedback initiatives and the generalizability of the results.
确定（1）医学登记处如何向医疗保健专业人员提供信息反馈，（2）这种反馈是否对护理质量产生任何影响，以及（3）反馈有效性的障碍和成功因素是什么。
1990 年 1 月至 2007 年 8 月期间在 MEDLINE Pubmed 中以英文发表的原始文章。
两名审查员独立筛选了 6223 篇原始文章的标题和摘要，以确定是否进一步审查。
我们使用标准化的数据提取表来收集有关反馈举措及其有效性的信息。仅对分析性论文（即试图客观地量化对护理质量的影响，并将这种影响与反馈作为一种干预措施联系起来的论文）描述了反馈的效果。为了分析有效性，我们根据反馈中添加的元素数量对举措进行了分类。
我们纳入了 53 篇论文，描述了 50 项反馈举措，其中 39 项是多方面方法的一部分。我们的结果证实了先前的研究结果，即向反馈策略中添加元素会积极影响其有效性。我们发现了 22 项分析性研究，其中 4 项研究发现所有结果衡量标准均有积极影响，8 项研究发现混合了积极影响和无影响，10 项研究未发现任何影响（既无积极影响也无负面影响）。在分析性研究中评估的 43 项护理过程措施中，有 26 项受到反馈举措的积极影响。在评估的 36 项护理结果措施中，有 5 项受到积极影响。影响反馈有效性的最常提到的因素包括：（对）数据质量的信任、收件人的动机、组织因素和反馈收件人的结果预期。
关于医学登记处信息反馈方法和效果的文献具有异质性，因此难以对其有效性得出明确结论。然而，积极的影响不能被忽视。虽然我们的审查证实了之前的研究结果，即护理过程措施比护理结果措施更能受到反馈的积极影响，但进一步的研究应尝试确定对反馈策略引起的行为变化敏感的护理结果措施。此外，评估反馈有效性的未来研究应更详细地描述其干预措施，以提高反馈举措的可重复性和结果的可推广性。
