Abstract
A modified Payne process and the JCAH intermediate outcome medical audits were applied to 6,980 cases in eight diagnostic categories within 22 hospitals, representing 1,321 attending physicians. Overall correlations between the two audits differed substantially from diagnosis to diagnosis, allowing for generally inconsistent and conflicting results when applied to a specific research question. Methods are illustrated for comparing the relative scaling (harshness) and sensitivity (discriminating power) of these two audit methods. The effects of the specificity of items, total number of items, outcome versus process indicators, and weights of items on the measurement characteristics of the audit methods are also discussed.
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