Thanks to everyone for answering my questions.
I would just like to pick up on a point made by Ben about the ethical
requirements for research versus audit. In England we find that some
Research Ethics Committees automatically waive review of a project if it is
deemed to be audit instead of research. I think this is unfortunate, as
audit projects can have ethical issues too. Isn't this a case of throwing
out the ethical issues with the bathwater?
Janet Harris
Academic Director, Health Sciences
University of Oxford
Centre for Professional Development
16/17 St Ebbes Street
Oxford ENGLAND
OX1 1PT
01865 286944/286942
>In the US, at least, increasingly there are some new regulatory
>requirements, which can help decide what is "audit" and what is "research".
>If you plan to publish the study (and thus contribute to acquiring a new
>knowledge) your activity may be called "research" and thus has to be
>approved by the IRB (Institutional REview Boards, similar to Ethics
>Committee elsewhere). If you activity is done for the purpose of improving
>your own practice, etc but with no intention to publish, there is no such a
>requirement in place, and hence it may be called "audit".
ben djulbegovic
> -----Original Message-----
> From: David Birnbaum [mailto:[log in to unmask]]
> Sent: 18 June 2002 21:49
> To: [log in to unmask]
> Subject: Re: audits as evidence
>
>
> Janet Harris posted:
>
> > ... audit can be part of a service or programme evaluation.
> Evaluation is
> > a form of research. After doing evaluations in North
> America for many
> > years, it was confusing for me to experience the National
> Health Service
> > definition of audit as 'not research'.
>
> Whether called audit, formative (or summative) evaluation, or survey,
> perhaps a key distinction emerging in this thread is one of
> funding and
> management responsibilities vs. a conceptual framework for
> strength-of-evidence?
>
> Kev and Badri posted pertinent examples, and I offered Last's
> definition of
> research involving "generalizable knowledge." Under that
> definition, I'd
> vote with Badri to consider the Tropman et al. study applied
> health service
> research. I might even vote to fund such studies from public
> sources since
> they provide generalizable knowledge about the evaluation and
> provision of
> health services when they address unknown ground. On a
> population-health
> level, it might even be worth funding a series of regional or national
> research studies to see how well programs are addressing
> community health
> needs over time. On the other hand, once a standard of care
> is defined and
> criteria for its evaluation set within a specific health service
> organization, then one responsibility of sound organizational
> management is
> on-going evaluation (which could still be considered applied
> research of
> interest to fewer stakeholders but essential to inform
> quality improvement
> decisions) that should be supported by that organization's operational
> budget rather than from external research funding
> competitions. Audit as a
> simple case-series or survey type research design provides an
> approach to
> gathering evidence that is relatively easy but susceptible to
> bias. I agree
> with Karen and Badri that its purpose defines whether a given
> audit project
> should be funded as research or as a normal management responsibility.
>
> David Birnbaum, PhD, MPH
> Adjunct Professor
> Dept. of Health Care & Epidemiology
> University of British Columbia, Canada
>
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