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Growing Literature, Stagnant Science? Systematic Review, Meta-Regression and Cumulative Analysis of Audit and Feedback Interventions in Health Care
This paper extends the findings of the Cochrane systematic review of audit and feedback on professional practice to explore the estimate of effect over time and examine whether new trials have added to knowledge regarding how optimize the effectiveness of audit and feedback.
We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE for randomized trials of audit and feedback compared to usual care, with objectively measured outcomes assessing compliance with intended professional practice. Two reviewers independently screened articles and abstracted variables related to the intervention, the context, and trial methodology. The median absolute risk difference in compliance with intended professional practice was determined for each study, and adjusted for baseline performance. The effect size across studies was recalculated as studies were added to the cumulative analysis. Meta-regressions were conducted for studies published up to 2002, 2006, and 2010 in which characteristics of the intervention, the recipients, and trial risk of bias were tested as predictors of effect size.
Of the 140 randomized clinical trials (RCTs) included in the Cochrane review, 98 comparisons from 62 studies met the criteria for inclusion. The cumulative analysis indicated that the effect size became stable in 2003 after 51 comparisons from 30 trials. Cumulative meta-regressions suggested new trials are contributing little further information regarding the impact of common effect modifiers. Feedback appears most effective when: delivered by a supervisor or respected colleague; presented frequently; featuring both specific goals and action-plans; aiming to decrease the targeted behavior; baseline performance is lower; and recipients are non-physicians.
There is substantial evidence that audit and feedback can effectively improve quality of care, but little evidence of progress in the field. There are opportunity costs for patients, providers, and health care systems when investigators test quality improvement interventions that do not build upon, or contribute toward, extant knowledge.
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- Title
- Growing Literature, Stagnant Science? Systematic Review, Meta-Regression and Cumulative Analysis of Audit and Feedback Interventions in Health Care
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
- Journal
Journal of General Internal Medicine
Volume 29, Issue 11 , pp 1534-1541
- Cover Date
- 2014-11-01
- 10.1007/s11606-014-2913-y
- Print ISSN
- 0884-8734
- Online ISSN
- 1525-1497
- Publisher
- Springer US
- Additional Links
- Topics
- Keywords
- audit and feedback
- scientific progress
- quality improvement
- systematic review
- cumulative analysis
- Industry Sectors
- Authors
- Noah M. Ivers MD, PhD (1)
- Jeremy M. Grimshaw PhD (2)
- Gro Jamtvedt PT (3)
- Signe Flottorp MD (3)
- Mary Ann O'Brien PhD (1)
- Simon D. French PhD (4)
- Jane Young MD (5)
- Jan Odgaard-Jensen PhD (3)
- Author Affiliations
- 1. Family Practice Health Centre and Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada
- 2. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Department of Medicine, University of Ottawa, 725 Parkdale Ave., Ottawa, Ontario, K1Y 4E9, Canada
- 3. Norwegian Knowledge Centre for the Health Services, 7004 St. Olavs Plass, 0130, Oslo, Norway
- 4. School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, 31 George Street, Room 222, Kingston, Ontario, K7L 3N6, Canada
- 5. Cancer Epidemiology and Services Research, Sydney School of Public Health, University of Sydney, Sydney, New South Wales, 2006, Australia


text: 500 pts Prostitution Ring Busted <Newsmembers What city did this occur in? Read the answer. Sign in to Participate Category: Trivia Ends: Wednesday July 10 at 12:16PM PDT Visit our sponsor: Indulge -- Ladies-Only Party Share on Facebook Share on Twitter More Leave a comment Send to a friend! Print this page Pin it! Reddit This! Share on Tumblr! More Ways To Get and Use Points Thanksgiving IndiansThanksgiving Trivia 2Who Were the Indians?When Was Thanksgiving?Thanksgiving TriviaDo They Know It's Christmas?

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Casa Palazzo Santa Flavia
Apartment | 1 bedrooms | sleeps 4
|Key Info
Casa Palazzo Santa Flavia (LOFT) Deluxe apartment 2-4 persons Palazzo Filangeri Landolina is located in the heart of via Maqueda 5 minute's walk from Piazza Vigliena (also known as Quattro Canti or Teatro del Sole). Once owned by the princes of St. Flavia, this noble building was part of the elegant framework running along the main town artery - laid out during the XVII and XVIII century by the duke of Maqueda, the Spanish viceroy of Cardines - adjoining at right angles the Cassaro, the ancient main road which linked the Palazzo Reale to the Harbour. Palazzo St. Flavia, as usual at that time, is the result of different architectural styles and reconstructions which, layer by layer, left their recognizable mark on the actual building. The baroque fa'ade, for instance, shares the volume of the ancient Palazzo Strozzi, dating back to the XVI century and rising on the adjacent side road Via Del Bosco. The apartment, completely restored in 2007, occupies St. Flavia Palace first floor and offers from its balconies a close view of Palazzo St. Elia and of the entire via Maqueda. The apartment mainly develops as an open space divided by low walls abiding both the regional rules set for the preservation of valuable historical buildings and, at the same time, the latest aesthetical suggestions. The broad XVI century groin vaulted living and dining room, which is looking onto the building inner yard, has been specifically planned for enjoyable social evenings. Leaving this room, you enter the fully equipped kitchen and studio area with its XIX century frescoed ceiling but provided also with a Wi-Fi internet point (free ADSL + laptop). The master bedroom with a walk-in closet/dressing area, the stone walled bathroom both with a tub and an oversize shower compartment and, at the far end, a small laundry room complete the fluid succession of differently shaped spaces. The apartment offers a full set of household white goods such as: washing machine, dish washing machine, microwave oven, electric toaster and kettle, tableware, kitchen utensils, cutlery,china iron and ironing board, hairdryer, bed linen and towels, cd/dvd player + LCD screen, underfloor heating, anti-theft device. No air conditioning is required since the thick ancient walls maintain the temperature fresh even in the hottest summer hours. The d'cor and furniture are a hybrid fusion of boundless imagination, inspiration and old and recent memories of which, if you like, you might become a new witness. This home reveals itself in a different way every day. No moment is ever the same and you have the chance to make your stay memorable. Once you leave the palace gate, be prepared to explore. The surrounding area, stretching inside the eastern boundaries of the administrative district of 'Palazzo Reale', is extremely lively and full of raw energy at every hour of the day thanks to its countless public institutions, shops and traditional backstreet markets. Coffee shops, pubs, restaurants, theatres keep it moving as night falls when people of different origin and background mingle together. As most part of the historical centre, this is actually a place where a peaceful multiethnic coexistence is fully realized. Local students, professionals, institutions' representatives live side by side with immigrates from the north of Africa, from sub-Saharian regions, from Sri-Lanka, from China and from many other ethnic groups. :
|Sleeps up to 4, 1 bedrooms
|Family friendly
|Great for children of all ages, Suitable for people with restricted mobility
|No pets allowed, No smoking at this property
Features and Facilities
|Internet access, DVD player
|Central heating, TV, CD player, Wi-Fi available
|Iron, Hair dryer
|Fridge, Washing machine
|1 bedroom, 1 bathrooms of which 1 Family bathrooms
|2 Sofa beds, Double beds (1), Dining seats for 6, Lounge seats for 6
|Linen provided, Towels provided
|Balcony or terrace
|Secure parking
The Sicily region
Sicily, right in the heart of the Mediterranean sea, has a cultural heritage unsurpassed by any other holiday destination. It's array of historical rulers have provided the island with unique architecture, art and traditions. The coastline is dramatic and beautiful (like the people) and the towns are a bustling hubbub of activities.
In the centre of the island sits the majestic Mt Etna, a still active volcano. A trip to the top is a must.
Being in Italy, and having such a rich history, Sicily has a wonderful selection of food & drink. The various cultures and natural local produce combine to make dishes that can be found nowhere else in the world.
Streets and alleys of Palermo:
can't get enough of walking in Palermo. Staring at the varied architecture, listening to the clips of conversations (just the tone of them), smiling back to curious and friendly faces' and suddenly ' a flash of green wings and a scream of a parrot!
Market places:
just dive into a real dealing and get ready for making a fool of yourself ' and don't get it so seriously if you put your fingers to the wrong places and get some strict looks from the market salesmen.
Bar Touring
in Piazzetta Porta Reale (Via Lincoln): very friendly staff and 10+ Sicilian style 'snacks' like arancinos and pepitos etc.
Availability Your dates are available
Guest reviewsPowered by TripAdvisor
Guest reviews no reviews
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Help other travellers decide where to stay
This holiday home hasn't got any reviews yet. The average rating on Holiday Lettings is four out of five. This place could be newly added or perhaps it's a well kept secret. Either way, it's time to reveal all.
This advert is created and maintained by the advertiser; we can only publish adverts in good faith as we don't own, manage or inspect any of the properties. We advise you to familiarise yourself with our terms of use.
You're booking with
Maurizio Giambalvo (Property Manager Maurizio Giambalvo (Property Manager VisitPalermo))
- 2 Years listed
Calendar last updated:08 Oct 2014
Based in Italy
- English
- French
- Spanish
- Italian
- Norwegian
Payment accepted
Paypal accepted
Credit cards accepted
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- Product Information
Product Description
Keep your cans cool while things heat up while watching your favorite basketball team go mad on the court. Our orange foam drink holder is perfect for getting together with friends and watching the game on TV or in the bleachers. Fits most cans. Our Basketball Can Cooler is priced per piece. Please order in increments of 1 Can Cooler.
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