Trial reportBMJ (Clinical research ed.)1995
Controlled trial of an audit facilitator in diagnosis and treatment of childhood asthma in general practice.
Trial report in BMJ (Clinical research ed.), 1995. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 5 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 5 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Interventions to modify health care provider adherence to asthma guidelines: a systematic review.Pediatrics · 2013Pooled it
- Primary care based clinics for asthma.The Cochrane database of systematic reviews · 2012Pooled it
- General practitioners' continuing education: a review of policies, strategies and effectiveness, and their implications for the future.The British journal of general practice : the journal of the Royal College of General Practitioners · 1998Pooled it
- Organisation of asthma care: what difference does it make? A systematic review of the literature.Quality in health care : QHC · 1996Pooled it
- Systematic review and meta-analysis of practice facilitation within primary care settings.Annals of family medicinePooled it
- Practice-tailored facilitation to improve pediatric preventive care delivery: a randomized trial.Pediatrics · 2014Trial
- Successful Trial of Practice Facilitation for Plan, Do, Study, Act Quality Improvement.Journal of the American Board of Family Medicine : JABFMTrial
- Practice level factors associated with enhanced engagement with practice facilitators; findings from the heart health now study.BMC health services research · 2020Article
- Decision tools in health care: focus on the problem, not the solution.BMC medical informatics and decision making · 2006Article
- Progress of unit based quality improvement: an evaluation of a support strategy.Quality & safety in health care · 2002Article
- Diagnosing asthma in young children.Current allergy and asthma reports · 2002Review
- Asthma guidelines: invited commentaries.Proceedings (Baylor University. Medical Center) · 2000Article
- The evaluation of a mental health facilitator in general practice: effects on recognition, management, and outcome of mental illness.The British journal of general practice : the journal of the Royal College of General Practitioners · 2000Article
- Article
- Changing doctor prescribing behaviour.Pharmacy world & science : PWS · 1999Article
- Enabling the implementation of evidence based practice: a conceptual framework.Quality in health care : QHC · 1998Article
- Effect of asthma and its treatment on growth: four year follow up of cohort of children from general practices in Tayside, Scotland.BMJ (Clinical research ed.) · 1998Article
- A survey of audit activity in general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 1998Article
- The facilitator effect: results from a four-year follow-up of children with asthma.The British journal of general practice : the journal of the Royal College of General Practitioners · 1997Article
- Clinical audit: more research is required.Journal of epidemiology and community health · 1995Article
Corrections and comments
- Commented on by
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo test whether an audit facilitator could alter the pattern of diagnosis and treatment of childhood asthma.
designRandomised stratified controlled trial.
setting12 general practices in Tayside. SUBJECTS: 3373 children aged 1-15 inclusive who had symptoms suggestive of asthma or possible asthma drawn from a systematic review of 10,725 general practice case records.
interventionChildren were targeted for a clinical review by their general practitioner or practice nurses.
main outcome measuresAsthma related consultations, prescriptions, hospital attendances, and health service costs 12 months before and after study.
resultsCompared with controls (n = 1563) the intervention group (n = 1585) had more practice initiated consultations for asthma (relative risk 2.18 (95% confidence interval 1.74 to 2.73)), new diagnoses of asthma (2.83 (2.26 to 3.54)), and past diagnoses reaffirmed (1.30 (1.08 to 1.58)), and they were more frequently prescribed inhaled cromoglycate (1.52 (1.02 to 2.25)). Hospital inpatient day rates fell from 152 to 122 in the intervention group and rose from 69 to 117 in the control group between the year before and the year after study. Total primary care costs rose from 30,118 pounds to 37,243 pounds in the intervention group and fell from 29,131 pounds to 27,990 pounds in the control group. Hospital care cost fell in the intervention group from 25,406 pounds to 20,727 pounds and rose in the control group from 12,699 pounds to 19,650 pounds.
conclusionAn audit facilitator can favourably influence the pattern of diagnosis and treatment of childhood asthma in general practice. This may have an impact on health service costs.
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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.