title: Effectiveness of report cards based on chart audits of residents' adherence to practice guidelines on practice performance: a randomized controlled trial.
abstract: BACKGROUND
  Medical record audits have been used to provide physicians with feedback about their compliance with preventive health and disease management recommendations.
  
  
  OBJECTIVE
  To determine if report cards summarizing medicine residents' preventive health and disease management practices can be used as a feedback tool to improve practice performance.
  
  
  METHODS
  Randomized, blinded, controlled study of 44 internal medicine residents using an individualized 78-item report card based on outpatient record audits.
  
  
  RESULTS
  Four hundred ninety-seven charts were retrospectively audited at baseline and 284 charts in follow-up. There were no significant differences in baseline performance between the residents in the intervention and control group. There were no differences in performance scores between residents receiving report cards and those who had not in immunizations, counseling, total preventive health, diabetes, hypertension, and total disease management.
  
  
  CONCLUSIONS
  Intensive data-based feedback using report cards may not be a successful way to improve ambulatory performance of medical house officers.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA. jennifer.kogan@uphs.upenn.edu
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Kogan
authors.forename: Eileen E
authors.initials: EE
authors.lastname: Reynolds
authors.forename: Judy A
authors.initials: JA
authors.lastname: Shea
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000592:standards; D003324:Coronary Artery Disease / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000517:prevention & control; D004521:Educational Measurement / Q000706:statistics & numerical data*; D030141:Feedback, Psychological; D005260:Female; D019983:Guideline Adherence / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D007396:Internship and Residency / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male; D008485:Medical Audit; D017410:Practice Guidelines as Topic; D011315:Preventive Medicine / Q000592:standards; D012189:Retrospective Studies; D014481:United States