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February 14, 1977


JAMA. 1977;237(7):643-644. doi:10.1001/jama.1977.03270340029011

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To the Editor.—  The SPECIAL COMMUNICATION by Drs Ashbaugh and McKean entitled "Continuing Medical Education: The Philosophy and Use of Audit" (236:1485, 1976) raises several issues and questions.

  1. In only 1.1% of the records examined were deficiencies found.

  2. The deficiencies illustrated by examples (removal of normal appendices, use of whole blood, failure to record laboratory tests prior to thyroidectomy) were probably well known before the audit began and could have been documented by far less elaborate methods.

  3. In hospital A, the difference between a 27% incidence of normal appendices removed in 1973 vs 17% and 14% in 1974 and 1975 may be as significant (or insignificant) as the difference between 10% normal appendices removed in 1973 vs 17% in 1974 and 1975 in hospital B.

  4. The statement that "the audit process is the most educational experience of all" is not supported by any evidence. What did