title: Reporting and design elements of audit and feedback interventions: a secondary review.
abstract: Audit and feedback (A&F) is a frequently used intervention aiming to support implementation of research evidence into clinical practice with positive, yet variable, effects. Our understanding of effective A&F has been limited by poor reporting and intervention heterogeneity. Our objective was to describe the extent of these issues.
  
  
  
  Using a secondary review of A&F interventions and a consensus-based process to identify modifiable A&F elements, we examined intervention descriptions in 140 trials of A&F to quantify reporting limitations and describe the interventions.
  
  
  
  We identified 17 modifiable A&F intervention elements; 14 were examined to quantify reporting limitations and all 17 were used to describe the interventions. Clear reporting of the elements ranged from 56% to 97% with a median of 89%. There was considerable variation in A&F interventions with 51% for individual providers only, 92% targeting behaviour change and 79% targeting processes of care, 64% performed by the provider group and 81% reporting aggregate patient data.
  
  
  
  Our process identified 17 A&F design elements, demonstrated gaps in reporting and helped understand the degree of variation in A&F interventions.
authors.affiliation: Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Colquhoun
authors.affiliation: Division of Psychology and Language Sciences, University College London, London, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Michie
authors.affiliation: Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA.|Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Sales
authors.affiliation: Family and Community Medicine, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Noah
authors.initials: N
authors.lastname: Ivers
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.|Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: J M
authors.initials: JM
authors.lastname: Grimshaw
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Kelly
authors.initials: K
authors.lastname: Carroll
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Chalifoux
authors.affiliation: Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Eva
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.|Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Jamie
authors.initials: J
authors.lastname: Brehaut
mesh_terms: D005246:Feedback; D006801:Humans; D008485:Medical Audit / Q000458:organization & administration*; D015397:Program Evaluation; D058996:Quality Improvement / Q000458:organization & administration; D011787:Quality of Health Care
keywords: Audit and feedback; Evidence-based medicine; Healthcare quality improvement; Implementation science