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An evaluation of Medline published paediatric audits from 1966 to 1999
Clodagh Sheila O'Gorman1, Yasir Ziedan, Michael Brendan O'Neill
1Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
Insights
Many published paediatric audits lack essential components, potentially undermining the audit process. Improving the quality of published audits is crucial for maintaining their value in clinical medicine and enhancing child healthcare.
Area of Science:
- Medical Research
- Healthcare Quality Improvement
- Paediatric Medicine
Background:
- Medical audits are essential for evaluating and improving healthcare quality.
- The historical quality of paediatric audits published between 1966 and 1999 requires assessment.
- Understanding the evolution of audit practices in paediatrics is vital for current quality improvement initiatives.
Purpose of the Study:
- To evaluate the quality of paediatric audits published from 1966 to 1999.
- To identify the presence of core audit elements in published paediatric studies.
- To provide recommendations for enhancing the quality of future paediatric audit publications.
Main Methods:
- A comprehensive Medline search was conducted using terms related to audit and child health.
- Inclusion criteria focused on core audit elements: healthcare topic, predefined standard, practice evaluation, and comparison to the standard.
- Empirical grading of standards was employed to assess the quality of included studies.
Main Results:
- Out of 442 articles reviewed, 303 pertained to paediatric healthcare.
- Only 38% of articles defined standards, and 30.4% performed an audit against a standard.
- Re-auditing was reported in only 5.9% of studies, with more instances after 1990.
Conclusions:
- A significant number of publications labeled as "audits" in paediatrics do not meet the core criteria of an audit.
- The publication of low-quality audits may negatively impact the perception and utility of the audit concept.
- Implementing suggestions for improving audit quality is recommended to enhance their value in clinical practice and child health outcomes.
Aim:
To evaluate the quality of paediatric audits from 1966 to 1999.
Methods:
A Medline search was performed using the MeSH terms audit, child, paediatric (and pediatric). Predefined core elements of audit were used as inclusion criteria for entry of an article into this study. These criteria were as follows: (1) an article deals with a healthcare topic; (2) a standard is predefined; (3) actual practice is evaluated; (4) actual practice is compared with the standard. The fifth criterion of audit, dissemination of information and reaudit, was not an inclusion criterion, as it was not used in the early years covered by this study. Empirical grading of standards was used.
Results:
The search yielded 442 articles, of which 303 (100%) were related to paediatric healthcare and were reviewed. Standards were defined in 115 (38%) articles. Audit against the standard was performed in 92 (30.4%) articles, of which 42 (45.6%) were published before, and 50 (54.3%) after, 1990. 18 (5.9%) articles were re-audited: 6 (14.3%) were published before, and 12 (24%) after, 1990. Of the 188 paediatric studies rejected, 119 (63.3%) described practice observations.
Conclusion:
Many articles in paediatrics are published as "audits", but they do not contain the core elements of audit. Although audit is a potentially valuable tool in clinical medicine, the publication of poor-quality audits may lead to the decline of the audit concept. Suggestions on ways to improve the quality of published audits are made.
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