Evidence map›Paper›PMID 19194332›Full record

SynthesisMedical care2009

Meta-analysis: audit and feedback features impact effectiveness on care quality.

Sylvia J Hysong

2 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Medical care, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 152 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
152citing papers in PubMed, 15 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.

NCT03000751 nacompletednot on this mapstarted 2016, after this paper: background citation

CT Dose Optimization and Standardization Endeavor (DOSE) Collaboratory

TypeinterventionalSponsorUniversity of California, San FranciscoRan2016 to 2020Enrolled864,080ConditionsIonizing Radiation Exposure, Quality ImprovementArmsSimple Audit Report, Multi-Component Intervention, In-Person Meeting
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

152 citing papers in PubMed, 15 syntheses or guidelines pooled it.

  1. Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025
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  4. Systematic review and narrative synthesis of computerized audit and feedback systems in healthcare.Journal of the American Medical Informatics Association : JAMIA · 2022
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92 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

1 author.

Sylvia J HysongHouston VA HSR&D Center of Excellence, Health Services Research & Development Service, Department of Veterans Affairs Medical Center, TX, USA. hysong@bcm.tmc.edu

Funding

Financial Incentives to Translate ALLHAT into PracticeR01HL079173 · NHLBI · BAYLOR COLLEGE OF MEDICINE · PI PETERSEN, LAURA A · 2005 to 2011
$3.3M
HSRD VA I01 HX003868NHLBI NIH HHS 1R01HL079173NHLBI NIH HHS R01 HL079173
6 · The paper itself

Abstract

backgroundAudit and feedback (A&F) has long been used to improve quality of care, albeit with variable results. This meta-analytic study tested whether Feedback Intervention Theory, a framework from industrial/organizational psychology, explains the observed variability in health care A&F research.

methodDATA SOURCE: studies cited by Jamtvedt's 2006 Cochrane systematic review of A&F, followed by database searches using the Cochrane review's search strategy to identify more recent studies. INCLUSION CRITERIA: Cochrane review criteria, plus: presence of a treatment group receiving only A & F; a control group receiving no intervention; a quantitatively measurable outcome; minimum n of 10 per arm; sufficient statistics for effect size calculations. Moderators: presence of discouragement and praise; correct solution, attainment level, velocity, frequency, and normative information; feedback format (verbal, textual, graphic, public, computerized, group vs. individual); goal setting activity. PROCEDURE: meta-analytic procedures using the Hedges-Olkin method.

resultsOf 519 studies initially identified, 19 met all inclusion criteria. Studies were most often excluded due to the lack of a feedback-only arm. A&F has a modest, though significant positive effect on quality outcomes (d = 0.40, 95% confidence interval = +/-0.20); providing specific suggestions for improvement, written, and more frequent feedback strengthened this effect, whereas graphical and verbal feedback attenuated this effect.

conclusionsA&F effectiveness is improved when feedback is delivered with specific suggestions for improvement, in writing, and frequently. Other feedback characteristics could also potentially improve effectiveness; however, research with stricter experimental controls is needed to identify the specific feedback characteristics that maximize its effectiveness.

Indexed as

FeedbackHealth Services ResearchMedical AuditQuality Assurance, Health CareHumansPsychology, IndustrialRandomized Controlled Trials as Topic

Identifiers

PMID19194332
PMCPMC4170834

What OpenQuestion holds

Textmetadata
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Read underepoch 390

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.