Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
1. Intent
Differentiating clinical audit, service evaluation, research and usual practice/ surveillance work in public health
USUAL PRACTICE
(in public health)
RESEARCH
SERVICE
EVALUATION*
Designed to manage
outbreak and help the
public by identifying and
understanding risks
associated.
Designed to investigate
outbreak or incident to
help in disease control
and prevention.
Designed to answer:
What standard does this
service achieve?
Designed to answer:
Does this service reach a
predetermined
standard?
Designed to answer:
What is the cause of this
outbreak?
Designed to answer:
What is the cause of this
outbreak? and treat.
Measures against a
standard.
Systematic, statistical
methods to allow timely
public health action.
Systematic, statistical
methods may be used.
Involves an intervention
in use only. The choice of
treatment is that of the
clinician and patient
according to guidance,
professional standards
and/or patient preference.
Involves an intervention
in use only. The choice of
treatment is that of the
clinician and patient
according to guidance,
professional standards
and/or patient preference.
May involve
administration of
interview or
questionnaire to those
exposed.
No allocation to
intervention: the health
professional and patient
have chosen intervention
before service evaluation.
No allocation to
intervention: the health
professional and patient
have chosen intervention
before audit.
No randomisation.
No randomisation.
No randomisation.
May involve
randomisation but not for
treatment.
* Service development and quality improvement may fall into this category.
CLINICAL AUDIT
SURVEILLANCE
Useful references
Casserat D, Karlawish JH, Sugarman J. Determining
when Quality Improvement Initiatives should be
considered research. JAMA. 2000; 283: 2275-80.
National Health and Medical Research Council
(NHMRC). When Does Quality Assurance in Health
Care Require Independent Ethical Review? Canberra:
National Health and Medical Research Council. (2003).
Smith R. Audit and Research. BMJ. 1992; 305: 905.
Available at: www.bmj.com
Wade D. Ethics audit and all shades of grey. BMJ.
2005; 330: 468. Available at: www.bmj.com
The National Ethics Advisory Committee (NEAC).
Ethical Review of Observational Research, Audit and
Related Activities. (2003). Available at:
www.neac.health.govt.nz
Contact details:
W www.hra.nhs.uk/
E nres.queries@nhs.net
Ref: 0987 December 2009 (rev. April 2013)
Health Research Authority 2013. Copyright and other intellectual
property rights in this material belong to the HRA and all rights are
reserved. The HRA authorises UK healthcare organisations to
reproduce this material for educational and non-commercial use.