Evidence map›Paper›PMID 16722539›Full record

ArticleImplementation science : IS2006

Audit and feedback and clinical practice guideline adherence: making feedback actionable.

Sylvia J Hysong, Richard G Best, Jacqueline A Pugh

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Implementation science : IS, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04356274 (Participatory System Dynamics vs Audit and Feedback), which is not on this map. Cited by 166 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
166citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04356274 naenrolling by invitationnot on this mapstarted 2019, after this paper: background citation

Participatory System Dynamics vs Audit and Feedback: A Cluster Randomized Trial of Mechanisms of Implementation Change to Expand Reach of Evidence-based Addiction and Mental Health Care

TypeinterventionalSponsorPalo Alto Veterans Institute for ResearchRan2019 to 2027Enrolled720ConditionsPTSD, Depression, Alcohol Use Disorder, Opioid Use DisorderArmsParticipatory System Dynamics (PSD), Audit and Feedback (AF)
3 · Its place in the literature

Who cites it

166 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Pooled it
  2. Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025
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  3. Strategies to reduce diagnostic errors: a systematic review.BMC medical informatics and decision making · 2019
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106 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Sylvia J HysongHouston Center for Quality of Care and Utilization Studies, Michael E. DeBakey VA Medical Center, Houston, Texas, USA. sylvia.hysong@med.va.gov
Richard G Best
Jacqueline A Pugh

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs a strategy for improving clinical practice guideline (CPG) adherence, audit and feedback (A&F) has been found to be variably effective, yet A&F research has not investigated the impact of feedback characteristics on its effectiveness. This paper explores how high performing facilities (HPF) and low performing facilities (LPF) differ in the way they use clinical audit data for feedback purposes.

methodDescriptive, qualitative, cross-sectional study of a purposeful sample of six Veterans Affairs Medical Centers (VAMCs) with high and low adherence to six CPGs, as measured by external chart review audits. One-hundred and two employees involved with outpatient CPG implementation across the six facilities participated in one-hour semi-structured interviews where they discussed strategies, facilitators and barriers to implementing CPGs. Interviews were analyzed using techniques from the grounded theory method.

resultsHigh performers provided timely, individualized, non-punitive feedback to providers, whereas low performers were more variable in their timeliness and non-punitiveness and relied on more standardized, facility-level reports. The concept of actionable feedback emerged as the core category from the data, around which timeliness, individualization, non-punitiveness, and customizability can be hierarchically ordered.

conclusionFacilities with a successful record of guideline adherence tend to deliver more timely, individualized and non-punitive feedback to providers about their adherence than facilities with a poor record of guideline adherence. Consistent with findings from organizational research, feedback intervention characteristics may influence the feedback's effectiveness at changing desired behaviors.

Identifiers

PMID16722539
PMCPMC1479835

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.