Clinical audit: more research is required.

Primary care * Unstructured and semi-structured interviews Is audit the most effective means of achieving quality improvement? * Secondary care * Participant and non-participant observation How much does audit cost? Audit as a national activity Cross sectional surveys Is audit cost-effective? Cohort and case control studies Is another quality mechanism likely to be more cost-effective Intervention trials Economic analysis: * Costs * Cost effectiveness * Cost benefit analysis * Cost effectiveness of audit compared with alternative activities 445