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A systematic review of electronic audit and feedback: intervention effectiveness and use of behaviour change theory

Overview of attention for article published in Implementation Science, May 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (87th percentile)
  • Good Attention Score compared to outputs of the same age and source (69th percentile)

Mentioned by

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28 tweeters

Citations

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54 Dimensions

Readers on

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158 Mendeley
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Title
A systematic review of electronic audit and feedback: intervention effectiveness and use of behaviour change theory
Published in
Implementation Science, May 2017
DOI 10.1186/s13012-017-0590-z
Pubmed ID
Authors

Timothy Tuti, Jacinta Nzinga, Martin Njoroge, Benjamin Brown, Niels Peek, Mike English, Chris Paton, Sabine N van der Veer

Abstract

Audit and feedback is a common intervention for supporting clinical behaviour change. Increasingly, health data are available in electronic format. Yet, little is known regarding if and how electronic audit and feedback (e-A&F) improves quality of care in practice. The study aimed to assess the effectiveness of e-A&F interventions in a primary care and hospital context and to identify theoretical mechanisms of behaviour change underlying these interventions. In August 2016, we searched five electronic databases, including MEDLINE and EMBASE via Ovid, and the Cochrane Central Register of Controlled Trials for published randomised controlled trials. We included studies that evaluated e-A&F interventions, defined as a summary of clinical performance delivered through an interactive computer interface to healthcare providers. Data on feedback characteristics, underlying theoretical domains, effect size and risk of bias were extracted by two independent review authors, who determined the domains within the Theoretical Domains Framework (TDF). We performed a meta-analysis of e-A&F effectiveness, and a narrative analysis of the nature and patterns of TDF domains and potential links with the intervention effect. We included seven studies comprising of 81,700 patients being cared for by 329 healthcare professionals/primary care facilities. Given the extremely high heterogeneity of the e-A&F interventions and five studies having a medium or high risk of bias, the average effect was deemed unreliable. Only two studies explicitly used theory to guide intervention design. The most frequent theoretical domains targeted by the e-A&F interventions included 'knowledge', 'social influences', 'goals' and 'behaviour regulation', with each intervention targeting a combination of at least three. None of the interventions addressed the domains 'social/professional role and identity' or 'emotion'. Analyses identified the number of different domains coded in control arm to have the biggest role in heterogeneity in e-A&F effect size. Given the high heterogeneity of identified studies, the effects of e-A&F were found to be highly variable. Additionally, e-A&F interventions tend to implicitly target only a fraction of known theoretical domains, even after omitting domains presumed not to be linked to e-A&F. Also, little evaluation of comparative effectiveness across trial arms was conducted. Future research should seek to further unpack the theoretical domains essential for effective e-A&F in order to better support strategic individual and team goals.

Twitter Demographics

The data shown below were collected from the profiles of 28 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 158 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 158 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 29 18%
Student > Master 22 14%
Student > Bachelor 16 10%
Student > Doctoral Student 13 8%
Student > Ph. D. Student 12 8%
Other 35 22%
Unknown 31 20%
Readers by discipline Count As %
Medicine and Dentistry 49 31%
Nursing and Health Professions 19 12%
Social Sciences 9 6%
Psychology 8 5%
Computer Science 5 3%
Other 27 17%
Unknown 41 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 16. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 August 2018.
All research outputs
#971,684
of 13,350,484 outputs
Outputs from Implementation Science
#319
of 1,380 outputs
Outputs of similar age
#32,228
of 263,954 outputs
Outputs of similar age from Implementation Science
#10
of 33 outputs
Altmetric has tracked 13,350,484 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,380 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.2. This one has done well, scoring higher than 76% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 263,954 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 87% of its contemporaries.
We're also able to compare this research output to 33 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.