Scribd
Upload
18 views59 pages

Audit PDF

The document discusses key concepts related to surgical audit and research including clinical audit, research, service evaluation, statistical terms, study designs, and reporting guidelines. It provides definitions and examples of terms like mean, median, mode, confidence intervals, types of errors, blinding, p-values, IMRAD structure, and the CONSORT checklist.

Uploaded by

Jeeva Surgeon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
18 views59 pages

Audit PDF

The document discusses key concepts related to surgical audit and research including clinical audit, research, service evaluation, statistical terms, study designs, and reporting guidelines. It provides definitions and examples of terms like mean, median, mode, confidence intervals, types of errors, blinding, p-values, IMRAD structure, and the CONSORT checklist.

Uploaded by

Jeeva Surgeon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 59

Surgical audit and

research
Introduction
• It is essential for a surgeon to understand the
educational and legal framework
• Health professionals are expected to undertake audit
and service evaluation as part of quality assurance
• Clinical audit is a process used by clinicians who seek to
improve patient care.
• two types of audit may be encountered: national
audits (e.g. in the UK, NHS England) and local/hospital
audits. Both are designed to improve the quality of
care.
Terms are frequently used in
statistics
• Mean: the result of dividing the total by the number of
observations (the average);
• Median: the middle value with equal numbers of
observations above and below – used for numerical or
ranked data;
• Mode: the value with the highest frequency observed –
used for nominal data collection;
• Range: the largest to the smallest value
• Confidence intervals : best guide to the possible range in
which the true differences are likely to lie. A confidence
interval that includes zero usually implies a lack of statistical
significance.
Normal data
• Normally, distributed data have a symmetrical, bell-
shaped curve, and the mean, median and mode all
lie at the same value.
Errors

• Type I error. Benefit is perceived when really there


is none (false positive).
• Type II error. Benefit is missed when it was there to
be found (false negative).
Eliminating bias
• One way to eliminate any bias inherent in the data
collection is to have observers or recorders who do
not know which treatment has been used (blinded
observer).
• patient is unaware of the treatment allocation
(single blind).
• neither patient nor researcher is aware of which
therapy has been used until after the study has
finished (double blind).
P value
• A P-value <0.05 is commonly taken to imply a true
difference. It is important not to forget that P =
0.05 simply means there is only a 1:20 chance that
the differences between the variables would have
happened by chance when in fact there is no real
difference
IMRAD
• Convention dictates that articles are submitted in
IMRAD form – introduction, methods, results and
discussion.
CONSORT

A group of scientists
and editors developed
the CONSORT
(Consolidated
Standards of Reporting
Trials) statement as a
checklist for the
conduct of good
randomised trials
It is useful to
construct a flow
diagram giving a
clear summary
of the research
protocol and its
requirements
Features of clinical audit that
differentiates it from research include
all except

A)Measures against a standard


B)Designed to answer the question: ‘Does this
service reach a predetermined standard?’
C)No randomisation
D)May involve randomisation
Ans
• D)May involve randomisation

• This is a feature of research


Designed and conducted to produce
information to inform the delivery of
best care is

• A) Research
• B) Clinical audit
• C) service evaluation
• D) none
Ans
• B) Clinical audit
Designed and conductedbsolely
to define or judge current care is

• A) Research
• B) Clinical audit
• C) service evaluation
• D) none
Ans
• C) service evaluation
Measurements are taken over a
period of time, not looking at the
whole population but selecting a
small similar group and expanding
results is

• A) longitudinal study
• B) case control study
• C) observational study
• D) none
Ans
• A) longitudinal study
All are components of IMRAD
except
• A)Aims
• B) Method
• C) Discussion
• D) Results
Ans
• A)Aims
t test is used in which of the
following data
• A) Numerical normally distributed
• B)Numerical but not normally distributed
• C) categorical
• D) all of the above
Ans
• A) Numerical normally distributed
CONSORT is a checklist for
conducting
• A) longitudinal study
• B) case control study
• C) observational study
• D) randomised controlled trials
Ans
• D) randomised controlled trials
best guide to the possible range in
which the true differences are likely
to lie is
• A) Median
• B) Mode
• C) Confidence interval
• D) Mean
Ans
• C) Confidence interval
ESCHAR trial is done for
• A) Pure venous ulcers
• B) Burns
• C) cellulitis
• D) all of the above
Ans
• A) Pure venous ulcers
Expand CONSORT
• A)Consolidated Standards of Reporting Trials
• B) Comprehensive Standards of Reporting Trials
• C)Consolidated Standards of ReadingTrials
• D)Consolidated study of Reporting Trials
Ans
• A)Consolidated Standards of Reporting Trials
All are features of normally
distributed data except
• A)symmetrical curve
• B)bell-shaped curve mean
• C)median = mode
• D) mean > median
Ans
• D) mean > median
Series of patients with a particular
disease or condition compared with
matched control patients is

• A) longitudinal study
• B) case control study
• C) observational study
• D) randomised controlled trials
Ans
• B) case control study
the result of dividing the total by
the number of
observations is

• A) Median
• B) Mode
• C) Confidence interval
• D) Mean
Ans
• D) Mean
Wilcoxon signed rank test to
assess which type of data

• A) Numerical normally distributed


• B)Numerical but not normally distributed
• C) categorical
• D) all of the above
Ans
• B)Numerical but not normally distributed
Benefit is perceived when really
there is none (false positive).

• A) Type 1 error
• B) Type 2 error
• C)Type 3 error
• D)Type 4 error
Ans
• A) Type 1 error
Benefit is missed when it was
there to be found (false negative)
is

• A) Type 1 error
• B) Type 2 error
• C)Type 3 error
• D)Type 4 error
Ans
• B) Type 2 error
All are definitions of observational
study except
• A)Evaluation of condition or treatment in a defined
population
• B)Retrospective: analysing past events
• C)Prospective : collecting data contemporaneously
• D)Series of patients with a particular disease or
condition compared with matched control patients
Ans
• D)Series of patients with a particular disease or
condition compared with matched control patients
Which of the following is false
• A)Service evaluation-No randomisation
• B)Clinical audit-No randomisation
• C)Research-No randomisation
• D)Research-May involve randomisation
Ans
• C)Research-No randomisation
the value with the highest
frequency observed –
used for nominal data collection

• A) Median
• B) Mode
• C) Confidence interval
• D) Mean
Ans
• B) Mode
True statement among the
following is
• A)P-value >0.05 is commonly taken to imply a true
difference.
• B)P-value <0.05 is commonly taken to imply a true
difference.
• C)P-value =0.05 is commonly taken to imply a true
difference.
• All of the above
Ans
• B)P-value <0.05 is commonly taken to imply a true
difference.
All are true except
• A)observers or recorders who do not know which
treatment has been used -blinded observer
• B)patient is unaware of the treatment allocation -
single blind
• C)neither patient nor researcher is aware of which
therapy has been used until after the study -double
blind
• D) None of the above
Ans
• D) None of the above
Thank You

You might also like