IS OWNERSHIP MORE IMPORTANT THAN THE SCIENTIFIC CREDIBILITY OF AUDIT PROTOCOLS - A SURVEY OF MEDICAL AUDIT ADVISORY GROUPS

Background. It is commonly accepted that ownership is an important fac tor in determining the acceptability and use of protocols or guideline s. Objectives. We aimed to determine whether Medical Audit Advisory Gr oups ((MAAGs) are prepared to accept and use audit protocols developed systematically by an external agency. Method. A postal questionnaire was sent to all 105 MAAG chairmen in England and Wales to seek their v iews on the external development of protocols, the inclusion of eviden ce-based prioritized criteria, the general design of the protocols iss ued by the Lilly Audit Centre and the numbers of practices reported by MAAGs as making use of at least one of the first four protocols issue d. Results. Ninety-five MAAGs (90 %) responded. Of these, 86 % were in favour of the external development of protocols, and 98% and 94%, res pectively, found evidence-based and prioritized criteria valuable; 98% felt the overall design and content of the Audit Centre protocols wer e excellent or good. A total of 1018 practices was known to have made use of one of these protocols, 261 taking part in multi-practice audit s organized by their MAAGs. Conclusion. Ownership is not necessarily m ore important than scientific credibility and/or perceived utility. Ex ternally developed audit protocols containing evidence-based, prioriti zed review criteria are acceptable to MAAGs, which are prepared to rec ommend their use in practice. Accordingly, such systematically develop ed protocols offer a promising and practical method for improving clin ical effectiveness. Further research is needed, however, to determine the comparative impact on standards of care of protocols and other met hods such as clinical guidelines.