Clinical Audit and Placebo Flashcards
what is an audit?
designed and conducted to produce information to inform delivery of best care
designed to answer a question
what is a service evaluation?
designed and conducted to define or judge current care
what kind of data analysis and collection does an audit or service evaluation entail?
analysis of existing data but may include admin of simple interview or questionare
why do we undertake clinical audits?
To ensure the best possible care for patients is provided
To ensure clinical practice is evidence-based
Audit is an integral part of Clinical Governance
Assist with the implementation of national initiatives (National Service Frameworks, NICE guidelines)
To improve working between multi-disciplinary groups
The GMC makes us do it!
what are some essential elements for clinical audits?
It should be patient focused
It should have a direct impact on patient care
Audit assists to improve patients’ experience of NHS
It can highlight an area of concern
It should be based on evidence based practice
Helps to ensure an efficient use of resources
what is the clinical audit cycle?
1 select topic
2. agree standards of best practice
3. define methodology
4. pilot and data collection
5. analysis and reporting
6. make recommendations
7. implement change
8. re audit
what are some effects of placebos?
Symptomatic relief
Rarely treat disease
Primarily address subjective and self-appraised symptoms
Can have negative effects – nocebo
Work even when the patient knows they have the placebo Kaptchuk et al 2010
Works on doctors too!
what are some complex neurobiology mechanisms involved in the placebo effect?
Neurotransmitters (e.g., endorphins, cannabinoids, and dopamine)
Activation of specific, quantifiable, and relevant areas of the brain (e.g., prefrontal cortex, anterior insula, rostral anterior cingulate cortex, and amygdala in placebo analgesia).
