title: A tale of two audits: closing the feedback loop on clearance rates of anogenital warts at three months.
abstract: Our management of anogenital warts was audited. By case-note review 95% were clear of original warts by three months (assuming wart clearance if patients stopped attending). However, by confirmed outcome (documented in case-notes or verified by telephone) only 81% were clear. The main reason for failure was inconsistent patient attendance. Subsequently, clinic staff were advised to emphasize the importance of regular treatment. A second audit was performed after 12 months. By case-note review 127/134 (95%) had achieved wart clearance, but by confirmed outcome only 74/89 (83%) were clear (P = 0.004). More men (89%) achieved clearance than women (80%). Again, the main reason for failure was inconsistent attendance. There are few data of outcomes in clinical practice at three months. Auditable outcome measures should be challenging yet achievable. Perhaps 90% clearance at three months is not achievable in clinical practice when allowing for the evidence base and patient choice. Is it time to revise the standard?
authors.affiliation: GU Medicine Department, Derriford Hospital, Plymouth,  UK.
authors.forename: W
authors.initials: W
authors.lastname: Davison
authors.forename: R
authors.initials: R
authors.lastname: Challenor
mesh_terms: D054869:Clinical Audit / Q000379:methods*; D003218:Condylomata Acuminata / Q000473:pathology / Q000628:therapy*; D019468:Disease Management; D005260:Female; D005831:Genital Diseases, Female / Q000473:pathology / Q000628:therapy*; D005832:Genital Diseases, Male / Q000473:pathology / Q000628:therapy*; D006748:Hospital Departments; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome