Skip to main content
SpringerLink
Log in

The quality of published paediatric audits and their standards

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

This article has been updated

Abstract

Objective

Audit is a recognised tool for evaluating the performance and improving the quality of health services. In Ireland and the UK, clear resources are available outlining audit elements. This study was undertaken to evaluate paediatric audits published from 2007 to 2020 to determine the adherence level to the definition of audit and to assess the quality of audit standards.

Design

PUBMED, MEDLINE and CINAHL databases were searched to identify relevant articles published in the English language. Each was reviewed to assess whether the following criteria were met: (1) a paediatric healthcare topic was described, (2) practice was reviewed, (3) the standard was specified, (4) an intervention was made and data collection was repeated to assess improvement. The quality of the standard for each true audit was graded utilising the Oxford Centre for Evidence-Based Medicine Levels of Evidence.

Results

Of 1230 published paediatric healthcare articles reviewed, 144 (11.4%) fulfilled the full criteria of an audit. Sixty-three (43.8%) true audits used the highest quality of evidence (level 1a and 1b), predominantly international or national guidelines. Fifty-six (38.9%) audits used the lowest quality of evidence (level 5), predominantly expert opinion.

Conclusions

There is a mismatch between the common usage of the term audit, and the definition, despite its incorporation into training curricula and institutional support. Many articles published as audits do not adhere to the definition of audit. There are variable levels of evidence supporting the standards utilised in published true audits.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Change history

  • 23 July 2022

    A spelling error in author name Michael B. O’Neill has been updated.

References

  1. Potter J, Fuller C, Ferris M (2010) Local clinical audit: handbook for physicians. Royal College of Physicians

  2. Standing committee on Postgraduate Medical Education (1989) Medical audit-the educational implications. SCOMPE, London

    Google Scholar 

  3. Johnston G, Crombie IK, Davies HT et al (2000) Reviewing audit: barriers and facilitating factors for effective clinical audit. Qual Health Care 9(1):23–36. https://doi.org/10.1136/qhc.9.1.23.PMID:10848367;PMCID:PMC1743496

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Faculty of Paediatrics (2021) Basic speciality training in paediatrics curriculum, 2nd edn. Ireland: RCPI, pp 14:19

  5. Rcpi.ie (2021) CPD explained. [online] Available at https://www.rcpi.ie/professional-competence/information-for-enrolled-doctors/cpd-explained/. Accessed 18 July 2021

  6. Partnership HQI (2016) Guide to involving junior doctors in clinical audit and quality improvement. HQIP, London

    Google Scholar 

  7. O'Gorman CS, Ziedan Y, O’Neill MB (2007) An evaluation of Medline published paediatric audits from 1966 to 1999. Arch Dis Child 92(4):309–311

  8. Cebm.ox.ac.uk (2021) Oxford Centre for Evidence-Based Medicine: Levels of Evidence (March 2009) — Centre for Evidence-Based Medicine (CEBM), University of Oxford. [online] Available at https://www.cebm.ox.ac.uk/resources/levels-of-evidence/oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009. Accessed 28 July 2021

  9. National Review of Clinical Audit Working Group (2019) National Review of Clinical Audit Report 2019, 1st edn. HSE, Ireland

    Google Scholar 

  10. National Centre for Clinical Excellence (2002) Principle for Best Practice in Clinical Audit. Radcliffe Medical Press, United Kingdom

    Google Scholar 

  11. Kumar P, Hashmi Y, Morad R et al (2020) Clinical Audit Platform for Students (CAPS): a pilot study. Postgraduate Medical Journal. pp postgradmedj-2020–138426

Download references

Acknowledgements

We thank Ms. Julia Reynolds, the Medical Information Specialist, Mayo University Hospital, Ireland, for her invaluable help with searching and retrieving the articles.

Author information

Authors and Affiliations

  1. Department of Paediatrics, Mayo University Hospital, Castlebar, Ireland

    Gráinne C. Larkin, Sinead A. Mulroy, Tomasz Nabialek, Monica Burlacu, Mushtaq Hussain & Michael B. O’Neill

Authors
  1. Gráinne C. Larkin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sinead A. Mulroy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tomasz Nabialek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Monica Burlacu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mushtaq Hussain
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Michael B. O’Neill
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All six authors made contributions to the design of the study and were involved in the acquisition of data, drafting of the manuscript and final approval of the version to be published. All named authors have no conflict of interest, financial or otherwise.

Corresponding author

Correspondence to Michael B. O’Neill.

Ethics declarations

Ethical statement

This study evaluated published paediatric articles and no individual patient data was assessed.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

What is already known on this topic?

• Audit is viewed as an essential part of practicing medicine.

What does this study add?

• There is a mismatch between the common usage of the term audit, and the definition, despite its incorporation into training curricula and institutional support.

• Evidence supporting standards used in published paediatric audits comes from varied sources—from high-quality international guidelines to low-quality local policies.

• Audit impact could be enhanced if the quality of the utilised standard was described by the authors.

Appendices

Appendix 1. Oxford centre for evidence-based medicine: Levels of evidence (March 2009)

Level

  • 1a Systematic review (with homogeneity*) of RCTs, inception cohort studies, level 1 diagnostic studies, prospective cohort studies or economic studies.

  • 1b Individual RCT (with narrow confidence interval), individual inception or prospective cohort study with > 80% follow-up, CDR validated in a single population.

  • 1c All or none, all or none case series.

  • 2a Systematic review (with homogeneity) of cohort studies or level 2 diagnostic studies.

  • 2b Individual cohort study including low-quality RCT, retrospective cohort study.

  • 2c “Outcomes” research, ecological studies.

  • 3a Systematic review (with homogeneity) of case–control studies.

  • 3b Individual case–control study, non-consecutive study.

  • 4 Case series, poor quality cohort and case–control studies.

  • 5 Expert opinion without explicit critical appraisal, or based on physiology, bench research or “first principles”.

Appendix 2. Top ten highest impact paediatric journals as of July 2021, compiled using the Journal Citation Reports database

Journal (descending impact)

Audit criteria mentioned in submission guidelines

Audit mentioned in submission guidelines

JAMA Pediatrics

No

No

Lancet Child & Adolescent Health

No

No

Journal Of The American Academy Of Child And Adolescent Psychiatry

No

No

Pediatrics

No

No

Pediatric Allergy And Immunology

No

No

Archives Of Disease In Childhood-Fetal And Neonatal Edition

No

Yes

Developmental Medicine And Child Neurology

No

No

Journal Of Adolescent Health

No

No

Pediatric Diabetes

No

No

European Child & Adolescent Psychiatry

No

No

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Larkin, G.C., Mulroy, S.A., Nabialek, T. et al. The quality of published paediatric audits and their standards. Ir J Med Sci 192, 1277–1280 (2023). https://doi.org/10.1007/s11845-022-03082-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-022-03082-y

Keywords

Search

Navigation