Audit and feedback: effects on professional practice

Audit and feedback (A&F) is a widely used strategy to improve professional practice among healthcare workers. A Cochrane systematic review analyzed 292 studies with 678 arms, of which 46% had low risk of bias. Most studies focused on physicians (81%) and examined prescribing practices (47%) and test ordering (35%). Synthesis of results showed a median absolute improvement in desired practice of 2.7%, while meta-analysis revealed a mean absolute increase of 6.2% (95% CI 4.1 to 8.2) with moderate-certainty evidence. Greater effects were observed with lower baseline performance and increased number of co-interventions. The study identified 48 unique behavior change techniques within the interventions.