Colquhoun Heather, Michie Susan, Sales Anne, Ivers Noah, Grimshaw J M, Carroll Kelly, Chalifoux Mathieu, Eva Kevin, Brehaut Jamie
Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.
Division of Psychology and Language Sciences, University College London, London, UK.
BMJ Qual Saf. 2017 Jan;26(1):54-60. doi: 10.1136/bmjqs-2015-005004. Epub 2016 Jan 25.
Audit and feedback (A&F) is a frequently used intervention aiming to support implementation of research evidence into clinical practice with positive, yet variable, effects. Our understanding of effective A&F has been limited by poor reporting and intervention heterogeneity. Our objective was to describe the extent of these issues.
Using a secondary review of A&F interventions and a consensus-based process to identify modifiable A&F elements, we examined intervention descriptions in 140 trials of A&F to quantify reporting limitations and describe the interventions.
We identified 17 modifiable A&F intervention elements; 14 were examined to quantify reporting limitations and all 17 were used to describe the interventions. Clear reporting of the elements ranged from 56% to 97% with a median of 89%. There was considerable variation in A&F interventions with 51% for individual providers only, 92% targeting behaviour change and 79% targeting processes of care, 64% performed by the provider group and 81% reporting aggregate patient data.
Our process identified 17 A&F design elements, demonstrated gaps in reporting and helped understand the degree of variation in A&F interventions.
审核与反馈（A&F）是一种常用的干预措施，旨在支持将研究证据应用于临床实践，其效果积极但存在差异。我们对有效审核与反馈的理解因报告质量差和干预措施的异质性而受到限制。我们的目标是描述这些问题的程度。
通过对审核与反馈干预措施进行二次审查，并采用基于共识的流程来确定可修改的审核与反馈要素，我们检查了140项审核与反馈试验中的干预措施描述，以量化报告局限性并描述这些干预措施。
我们确定了17个可修改的审核与反馈干预要素；对其中14个要素进行了检查以量化报告局限性，并使用所有17个要素来描述干预措施。这些要素的清晰报告率从56%到97%不等，中位数为89%。审核与反馈干预措施存在很大差异，仅针对个体提供者的占51%，针对行为改变的占92%，针对护理过程的占79%，由提供者群体实施的占64%，报告汇总患者数据的占81%。
我们的流程确定了17个审核与反馈设计要素，揭示了报告中的差距，并有助于了解审核与反馈干预措施的差异程度。
