Audit Standards Research Articles

Results of a multicenter 4D computed tomography quality assurance audit: Evaluating image accuracy and consistency

Background and purpose4D Computed Tomography (4DCT) technology captures the location and movement of tumors and nearby organs at risk over time. In this study, a multi-institutional multi-vendor 4DCT audit was initiated to assess the accuracy of current imaging protocols. Materials and methodsTwelve centers, including thirteen scanners performed a 4DCT acquisition of a dynamic thorax phantom using the institution’s own protocol with the in-house breathing monitoring system. Five regular and three irregular breathing patterns were used. Image acquisition and reconstruction were followed by automated image analysis with our in-house developed 4DCT QA program (QAMotion). CT number accuracy, volume deviation, amplitude deviation, and spatial integrity were assessed per pattern using both the segmented volumes and line profiles. ResultsRegular breathing curves showed relatively accurate results across all institutions, with mean volume and CT number deviations and median amplitude deviation below 2%, 5 HU and 2 mm, respectively. Results obtained for irregular patterns showed more variation across the institutions. Volume and CT number deviations co-occurred with a blurring of the sphere, interpolation, or double-structure artifacts that were confirmed through the line profiles. For some of the irregular patterns, amplitude deviations up to 6 mm were observed. Maximum Intensity Projection (MaxIP) correctly captured the applied motion amplitude with deviations across all institutions within 2 mm except for double amplitude pattern. ConclusionsAll centers invited to participate in the audit responded positively, highlighting the need for a comprehensive yet easy-to-execute 4DCT quality assurance program. The largest variances between the results from one institution to another confirmed that a standardized 4DCT audit is warranted.

Do physician networks with standardized audit and feedback deliver better quality care for older patients compared to regular care?: a quasi-experimental study using claims data from Bavaria, Germany.

Physician networks (PNs) are a recent development in Germany, designed to improve the coordination and quality of healthcare. We compared the performance of PNs that use a standardized system of audit and feedback to that of regular care. We analysed a large sample of claims data from Bavaria, Germany, using nearest-neighbour propensity score matching. Patients who had ambulatory care-sensitive conditions (ACSCs) and were enrolled in PNs were matched with control patients receiving regular care. We examined potentially avoidable hospitalizations related to the 13 most common ACSCs (primary endpoints), as well as processes-of-care indicators for disease prevention, pharmacotherapy and coordination of care. There were no significant differences in rates of potentially avoidable hospitalizations between the two groups. However, the networks showed higher vaccination rates, increased participation in disease management programmes, and more frequent use of referrals when consulting specialist physicians. On average, network patients visited a greater number of specialists and had lower continuity of care compared to patients receiving regular care. Polypharmacy and PRISCUS-list prescriptions were more prevalent in the networks. PNs using audit and feedback do not appear to perform better than regular care in preventing hospitalizations due to ACSCs. However, they do perform better in disease prevention measures while showing inconclusive results for care coordination and pharmacotherapy. Further research is needed to understand effective collaboration among providers and its impact on the quality of care within PNs.

Development of Risk-Based State-Owned Enterprises Performance Audit Framework to Enhance Company Value

In the face of fierce economic competition among State Owned Enterprises (SOE), encouraging each company to grow its corporate value through the development of a risk-based performance audit framework may be the best option for SOEs in Indonesia. SOE management can make ongoing improvements and respond rapidly to market changes by detecting company performance risks. The purpose of this research is to develop an SOE risk-based performance audit framework in order to increase company value. The Analytical Hierarchy Process (AHP) method was utilized to create an effective and efficient performance audit framework based on expert justification. The study's findings indicate that the Supreme Audit Institution (BPK) strategy’s main priorities for the construction of the SOE risk-based performance audit framework include three important aspects: 1) synergy between BPK audits and SOE risk management and risk assessment by SOE internal auditors; 2) development and improvement of SOE risk management quality, and 3) effective risk assessment by SOE internal auditors. This strategy is supported by various major variables, including SOE risk management, risk assessment by SOE internal auditors, BPK audit scope, BPK audit standards, BPK audit guidelines, and BPK auditor competencies.

A DESCRIPTIVE STUDY TO ASSESS THE PREVALENCE OF ALCOHOL DEPENDENCE AMONG ADULTS LIVING IN SELECTED RURAL COMMUNITY AREA OF SHANKARPUR, SAHASPUR, DEHRADUN

Aim: A study was done to assess the Prevalence of Alcohol Dependence among Adults Living in selected Rural Community Area of Shankarpur, Sahaspur, Dehradun. Design- Non experimental descriptive research design Materials and Method: The Conveniece sampling technique was utilized to select the sample. The sample size of the research study were 100 Adults . To assess the prevalence , standardized tool AUDIT was used . The data analyzed in term of the objectives of the study using descriptive and inferential statistics. Results: The result reveals that the most of the adults were having Low risk of Alcohol Dependence some of the study samples were having High Risk of Alcohol Dependence. While 5% of samples were at Possible Risk of Alcohol Dependence. The major findings represents the most of Alcohol Dependent Adults are in age group of 20-30 yrs greater members of Adults are Hindus (approx 71%) whereas 1% were Christian. The Highest number of Alcohol Dependent population lies under Increasing Risk that is 50%, whereas only 5% lies under possible Risk and rest 21% population lies under high risk and 24% under Lower Risk. The chi square values for socio demographic variables are Age(6.014), Religion(2.875), gender(14.260), Marital Status(14.256), Educational Qualification(33.590), Employment Status(14.616), Income(0.95), Family Type(8.22), Source Of Income(9.108), Health Status(0.76). The study depicts that only gender and Educational Qualification are the only sociodemographic variables that are significant. Also the study reveals that majority of alcohol dependent Adults are Males with 82% and rest 18% are females. Conclusion: The majority of alcohol dependent Adults are Males with 82% and rest 18% are females.

Audit of non-financial reporting: what standard should be used?

A business entity of whatever kind seeks to operate in long-term perspective by achieving the strategies set out by it, including the strategies pertaining to social justice, environmental protection, friendly use of natural resources and their renewal. It is also a matter of the society’s concern. It is for this reason that non-financial reporting for sustain­able development, provided by business entities, is demanded by users. The verification of non-financial information is assigned to independent auditors. Although auditors use the International Standard 3000 “Assurance Engagements Other Than Audits or Reviews of Historical Financial Information” for the verification purposes, the International Standard 3410 “Assurance Engagements on Greenhouse Gas Statements” can also be applied for specialized spheres. When non-financial information is submitted together with financial re­porting, the International Standard 720 (revised) “The auditor’s responsibilities relating to other information” will be applicable. On the request of international donor organizations, an auditor is allowed to use the International Standard 4400 “Agreed-upon procedures engagements”. Given that the International Standard 3000 is the most demanded among the auditors, the International Auditing and Assurance Standards Board provided a guid­ance on its application. The phases of non-financial reporting audit and their content were clarifi ed on the basis of the International Standard 3000. The choice of an international standard depends on the conditions of an engagement and relies on the professional judg­ment of an auditor. Irrespective of a chosen standard, an auditor bears the responsibility for the assessment of published non-financial reports for sustainable development. Real­izing the responsibility before users of non-financial reporting, an auditor must assure the quality of his services in keeping with the requirements of the International Standard on Quality Management (ISQM 1). The working document of an auditor “Quality assessment of assurance engagements other than audits or reviews of historical financial information (non-financial reporting)” was elaborated, which would help assure the internal control of auditing at engagement level. This document is standardized and can be used in the auditing practice.

The Association Between Changes in Key Audit Matters and Earnings Management Behavior in Companies

Abstract Auditing Standards No. 58 “Communication on Critical Audit Issues in Auditing Report” in April 12, 2016. These new standards effect and regulate public listed companies to keep step with international auditing standards starting from Year 2016. The purpose of this study is to explore the relationship between the changes in key audit matters and earnings management, and to understand the relationship between the changes in key audits and the degree of corporate earnings management. The results of the study show that after controlling the endogenous nature of earnings management variables through the two-stage method of instrumental variables, the degree of earnings management is significantly negatively correlated with the change in the number of accounting items disclosed in the key audits of the auditor's audit report. That is to say, when the degree of management of earnings management is higher, the possibility that the number of items of key check items increases is lower, When the degree of management of earnings management is higher, the probability of the number of items for key check items is reduced. and the tendency is not to change the disclosure items of key check items. Keywords: Key audit matters, Endogeneity, Earnings management.

The Cost of Becoming Informed and Audit Fees

Auditing standards instruct external auditors to read public information to mitigate management’s information advantage in hiding earnings management and fraud. The transparency of this information, and thus the cost of becoming informed using public information, varies across firms. We argue this cost of becoming informed creates an opportunity for earnings management, increasing audit risk. This study finds that higher costs of becoming informed are related to higher audit fees. In addition, we show that executive equity risk-taking incentives and an attitude towards aggressive reporting exacerbate the effect of the cost of becoming informed on audit fees, suggesting complementary effects of these fraud dimensions on audit pricing. These results are more likely due to audit firms charging risk premiums rather than doing additional audit work. This paper contributes to recent research on the costs of becoming informed and to research on the relation between management compensation and auditor compensation.

Implications of Integrating SAF-T into an ERP System

The integration of SAF-T (Standard Audit File for Tax) into an ERP system helps companies improve their tax operations by simplifying tax reporting, increasing operational efficiency, legal compliance and data quality. In addition, SAF-T integration can help companies optimize their processes and correct their workflow, leading to greater efficiency and better data visibility. It is important for all companies to ensure that the accounting system they use is compatible with the SAF-T format and that the implementation is done correctly. Therefore, the long-term benefits may outweigh the costs and risks involved, as evidenced by the data collected using the questionnaire. The purpose of this research is to provide a good understanding of the implications associated with the integration of SAF-T into an ERP system, so that companies can make informed decisions about the implementation of this solution. The questionnaire conducted on a number of significant respondents led to the achievement of the set objective. Concurrently, the advantages and disadvantages observed for all involved parties were pursued: companies, suppliers, and tax administrations, thus outlining a clear picture of the requirements to which taxpayers must respond from the beginning of year 2022.

АУДИТ БЕЗПЕРЕРВНОСТІ ДІЯЛЬНОСТІ ПІДПРИЄМСТВ

The article is devoted to the substantiation of the prerequisites and priorities for the development of the methodology and improvement of the organizational and methodological provisions of the audit of business continuity in the context of the requirements of the International Auditing Standards (IAS), changes in domestic legislation regarding the publication of financial statements of business entities in the context of military operations in Ukraine. The purpose of the study is to substantiate the priorities of the methodology development and improvement of the organizational and methodological provisions of the audit of the continuity of the activities of enterprises in conditions of uncertainty. The object of the study is the audit of the continuity of the enterprises. The methods used in the research: scientific knowledge, the method of generalization, comparison, logical - meaningful, methods of induction and deduction, analysis. The hypothesis consists in the assumption of the need for the development of methodology and the development of recommendations for improving the organizational and methodological provisions of the audit of business continuity in the context of the requirements of the ISA, changes in domestic legislation regarding the publication of financial statements based on the assumption of business continuity in the conditions of military operations in Ukraine and ensuring the awareness of interested persons about the current state of the enterprise's performance and the potential of its continued viability. Presenting main material. The prerequisites, the problematic field of issues that affect the assumption of continuity and the priority directions of the audit of the continuity of the enterprises' activities are determined. The basic provisions for the development of the methodology of the audit of the continuity of the activities of enterprises have been developed, which provide for an interconnected and complex solution to the tasks of improving the organizational and methodological principles of the audit in the context of the requirements of the ISA and taking into account changes in the domestic legislation regarding the publication and audit of financial statements by economic entities in the conditions of military operations in Ukraine. The classification of factors influencing the assumption of continuity of activity and the procedures for their assessment by segments are provided. The need to assess the loss of economic benefits from risk situations and reserves for their coverage is substantiated using the example of accounts receivable. The sequence of the audit process is presented and the elements of the methodology, criteria and objects of the business continuity audit are disclosed. To ensure the quality of the audit, additional analytical procedures based on the use of the Balanced Scorecard (BSS) and the methodology of integrated analysis of continuity, which covers four blocks of indicators: financial status, efficiency, added value, and the Balanced Scorecard system, are proposed. The originality and practical significance are: the provisions on the development of the methodology of the audit of the continuity of the enterprises' activity on the modern paradigm of the requirements of the ISA and changes in the domestic legislation; methodological recommendations regarding the sequence of the audit process of business continuity; a method of comprehensive analysis of the continuity of activity, the implementation of which allows to assess the effectiveness of management and the potential for ensuring the continuous viability of the enterprise. Conclusions. The need for the development of the methodology for the audit of the continuity of activities of enterprises arises from the requirements of the IASB and ISA, changes in the domestic legislation regarding the publication of financial statements based on the assumption of the continuity of business entities in the conditions of military operations in Ukraine, and the need to assess the potential for ensuring the continuous viability of the enterprise and the effectiveness of management. The implementation of the developed provisions for the development of the methodology of the audit of business continuity on the new paradigm and recommendations for its organizational and methodological support will contribute to the improvement of the quality of the audit. The proposed analytical procedures for assessing the influence of non-financial factors on the creation of added value based on a system of balanced indicators provide an opportunity to determine the critical segments of the enterprise's activity in the directions of business processes and obtain sufficient and acceptable audit evidence to provide information about the continuous viability of the enterprise. The use of the methodology of complex analysis of continuity allows you to form qualitative information for the preparation of a conclusion about the current state of the enterprise's performance, management efficiency and continuous viability of the enterprise in conditions of uncertainty.

Female Athlete Representation and Dietary Control Methods Among Studies Assessing Chronic Carbohydrate Approaches to Support Training.

The aim of this audit was to assess the representation of female athletes, dietary control methods, and gold standard female methodology that underpins the current guidelines for chronic carbohydrate (CHO) intake strategies for athlete daily training diets. Using a standardized audit, 281 studies were identified that examined high versus moderate CHO, periodized CHO availability, and/or low CHO, high fat diets. There were 3,735 total participants across these studies with only ∼16% of participants being women. Few studies utilized a design that specifically considered females, with only 16 studies (∼6%) including a female-only cohort and six studies (∼2%) with a sex-based comparison in their statistical procedure, in comparison to the 217 studies (∼77%) including a male-only cohort. Most studies (∼72%) did not provide sufficient information to define the menstrual status of participants, and of the 18 studies that did, optimal methodology for control of ovarian hormones was only noted in one study. While ∼40% of male-only studies provided all food and beverages to participants, only ∼20% of studies with a female-specific design used this approach for dietary control. Most studies did not implement strategies to ensure compliance to dietary interventions and/or control energy intake during dietary interventions. The literature that has contributed to the current guidelines for daily CHO intake is lacking in research that is specific to, or adequately addresses, the female athlete. Redressing this imbalance is of high priority to ensure that the female athlete receives evidence-based recommendations that consider her specific needs.

An Assessment of State-Level Planning for Physical Activity Promotion in the United States.

The prevalence and attributable risk of disease due to physical inactivity require it to be made a public health priority. Public health planning allows for prioritization and resource allocation, particularly at the state and local levels. The extent to which state planning efforts for physical activity exist in the United States is unknown. The purpose of this paper is to describe the scope in which physical activity is incorporated in state-level public health plans in the United States, with an emphasis on alignment with the national guidelines and the National Physical Activity Plan. A standardized internet search audit was developed and conducted for each of 50 US states and the District of Columbia between May 2017 and January 2018 to determine the prevalence and characteristics of health planning documents that include physical activity. Data abstracted for analysis used a standardized search protocol that included the components of the Physical Activity Guidelines for Americans and the US National Physical Activity Plan. Results found that most states had between 4 and 6 chronic disease prevention and control plans that mention physical activity; however, it was inconsistently aligned with recommendations from both the Guidelines and the National Plan. Only 2 states had stand-alone public health planning documents explicitly dedicated to physical activity promotion. No state planning documents addressed children and adolescents, adults, and older adults simultaneously. To be maximally effective, state public health planning for physical activity should be made a priority and these efforts should align as much as possible with current guidance from the Physical Activity Guidelines for Americans and the US National Physical Activity Plan.

A study on university staff s perspective on the harmonization of the internal audit system within the framework of International Internal Auditing Standards

Purpose- In this study, it is aimed to determine the problems experienced during the implementation of the internal audit system in state universities, which are a public administration, within the framework of international internal audit standards. Solution suggestions were made to the identified problems. In this research, a field study was conducted to determine the perceptions of senior supervisors working at Dicle University about the internal audit system at the university and their thoughts on compliance with international auditing standards. Methodology- The application part of the research consists of two parts. The first part consists of 5 questions to determine the demographic characteristics of the personnel participating in the research. In the second part of the research, it consists of 26 statements that will determine the opinions of the personnel on the harmonization of internal audit with international internal audit standards within the scope of the study. Findings- In general, it is seen that the participants of the research have an indecision about their working statements. Particularly, while disagreement comes to the fore in statements about international auditing standards, it is observed that the state of agreeing with statements about the role of internal auditing has increased. Conclusion- As a result of this study, it is thought that the internal audit activities of the university staff are insufficient, there is not enough internal auditor in the university and the information about the internal audit activities is insufficient. In particular, the university should attach importance to the awareness-raising activities of the senior management personnel regarding internal audit. Because internal audit activities directly contribute to the efficient work of university personnel. Therefore, in-service training activities should be increased to increase the efficiency of internal audit units in universities. In addition, it is seen that there are not enough internal audit personnel in universities. In particular, universities should allow more internal auditors to work on this issue. Keywords: Internal auditor, internal audit, international internal audit standards, university staff, Law No. 5018. JEL Codes: M40, M42, M49

Comparison of International and Local Auditing Standards: Practical Implications

This qualitative literature review explores the practical implications of auditing standard convergence, focusing on audit quality and financial reporting practices. The research aims to analyze the impact of international auditing standards, particularly the International Standards on Auditing (ISAs), on audit quality across different jurisdictions. The methodology involves a systematic search and analysis of relevant academic articles, books, reports, and scholarly sources. Data collection includes comprehensive searches of academic databases and hand-searching for relevant journals. Data analysis employs thematic analysis and quality appraisal criteria for evaluating qualitative research. The findings suggest that the adoption of ISAs is associated with improvements in audit quality due to their principles-based approach and emphasis on professional judgment and skepticism. However, the extent of improvement varies depending on the regulatory environment and institutional context. Challenges in achieving convergence arise from differences in legal systems, cultural norms, and regulatory environments across countries. Despite efforts towards convergence, discrepancies exist in research findings regarding the impact on financial reporting quality. Factors moderating this relationship include regulatory oversight, contextual differences, and institutional infrastructure. The study underscores the need for nuanced approaches to standard-setting and implementation to address these challenges effectively.

Development of Multi Standard Information Technology Governance Audit Tool with SDLC Approach

In the era of digitalization, business organizations are competing to improve the quality of their services by utilizing information technology. Reliable information technology applications can be used to help the company's operations become better, while improper application of information technology can slow down the process. The process of establishing information technology through IT governance audits will optimize the application of information technology in a business. The implementation of an IT audit generates plenty of data that must be appropriately managed. Audits conducted using traditional systems frequently encounter issues such as difficulties maintaining audit indicator data, manually keeping of evidence at risk of getting damaged or lost, the process for generating reports is quite long, the audit monitoring operations are ineffective, and because there are numerous types of standards with different indicators, multiple tools are required while performing audits. In order to answer these issues, this study implemented a multi standard information technology governance audit tool that capable of managing audit activity data from many standards in a single system. The PHP and javascript programming languages, MySQL database, as well as the Laravel and VueJS Frameworks, will be used in the construction of this audit tool. The SDLC method was applied in this study, with numerous stages including planning to maintenance. Through blackbox testing on the various functions contained in the developed multi-standard audit tool, it is shown that the system can function as expected or intended. As well as through the usability testing questionnaire, it was concluded that the multi-standard audit tool developed had fulfilled the usability aspects.

Comments of the AFAANZ Auditing and Assurance Standards Committee on the Proposed Standard on Assurance Engagements over GHG Emissions Disclosure

AbstractThe New Zealand External Reporting Board (XRB) issued for public comment a standard on Assurance Engagements over GHG Emissions Disclosure. The Auditing and Assurance Standards Committee of AFAANZ prepared a submission, based on the findings reported in published research, responding to a number of the questions asked by the XRB. This technical note presents the formal submission made to the XRB.

002 National clinical audit on the management of Stevens–Johnson syndrome/toxic epidermal necrolysis in adults

Abstract UK guidelines for the management of Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) in adults, published by the British Association of Dermatologists (BAD) in 2016, outline a set of audit standards (Creamer D, Walsh SA, Dziewulski P et al. U.K. guidelines for the management of Stevens–Johnson syndrome/toxic epidermal necrolysis in adults 2016. Br J Dermatol 2016; 174:1194–227). Our aim was to audit the current management of SJS/TEN in adults against audit standards in the BAD guidelines. BAD members were invited to submit data on five consecutive adults with SJS/TEN per department over an 8-week period in 2022. All data were obtained from respondents using a Microsoft Excel spreadsheet proforma returned to the BAD by email. No patient-identifiable data were requested. Initial data extraction was conducted using a novel and reproducible program written in the R statistical language (V3.7 and the readxl, ggplot2 and ggthemes packages). The data analysis was also performed using Microsoft Excel. Thirty-nine (29%) dermatology centres in the UK participated and data for 147 adults with SJS/TEN were collected. Within 24 h of a diagnosis being made or suspected, the following were documented: Severity-of-Illness Score for TEN (SCORTEN) for 52% (n = 76/147) of submitted cases, list of medications for 77% (n = 113) and timelines for commencement/alterations of medications for 71% (n = 104). Initial assessment was of the eyes (by an ophthalmologist) for 48% (n = 71) of cases, the mouth in 88% (n = 130), the genital skin in 70% (n = 103) and the urinary tract in 63% (n = 93). In the first 10 days after a suspected or confirmed diagnosis of SJS/TEN, daily assessments of the mouth were documented in 18% (n = 26) of cases, the eyes in 8% (n = 12) and the urinary tract and genital skin in 10% (n = 14). Documentation regarding advice on (i) avoidance of the culprit drug was present for 58% (n = 76/130) of cases and (ii) request for a medic alert bracelet/amulet in 6% (n = 9/147). In adults with SJS/TEN, drug causality assessment was documented adequately. Initial assessment of the mouth, eyes, urinary tract and genital skin was good to fair; however, daily assessments were poor. Other audit standards that require improving include documentation of SCORTEN and advice to avoid the culprit drug and request a medic alert bracelet/amulet. In adults with SJS/TEN, there are multiple points in the assessment pathway that require careful documentation and regular review. These are a challenge for many clinical inpatient environments. Care within a burns unit or similar may not be possible for all. This audit suggests that some form of assessment and clinical review checklist might enable colleagues to maintain standards outlined in the guideline. Among these, use of SCORTEN, advice to avoid the culprit drug and requests for a Medic Alert bracelet/amulet are key.

DS06 Does the content of patient information leaflets reflect real-life practice? A comparison of four patient information leaflets in Mohs micrographic surgery

Abstract In our experience, patients referred for Mohs micrographic surgery (MMS) often have unrealistic expectations, anticipating defects that are small in size and depth, and incorrectly describe the procedure as removal of skin cancer by ‘taking away thin slices’ or ‘skimming the skin layer by layer’. This observation prompted us to critically appraise four widely accessed online patient information leaflets (PILs) on MMS produced by the British Association of Dermatologists, the American Academy of Dermatology, Dermnetnz.org and the European Society of Micrographic Surgery. Our aim was to evaluate the wording used and propose evidence-based changes to help manage patients’ expectations. We focused on two core themes: (i) excision of tumour by MMS, including the number of stages, and (ii) cosmetic benefit of MMS over standard excision (SE). All of these PILs state the need for ‘stages’ to achieve margin clearance, with an initial margin of excision as low as 1 mm per stage mentioned in one PIL. The leaflets suggest cosmetic benefit and tissue preservation of MMS over SE, and one leaflet ranked this higher than other advantages offered by MMS. We feel that these points are overstated and better addressed with evidence-based facts. Studies have shown that 60% of cases of MMS are cleared in one stage; > 90% of tumours are cleared within two stages, and the number of patients needing three or more stages is only 6% (Macfarlane L, Waters A, Evans A et al. Seven years’ experience of Mohs micrographic surgery in a UK centre, and development of a UK minimum dataset and audit standards. Clin Exp Derm 2013; 38:262–9). In our experience, a surgical margin of 1 mm is not feasible in MMS. There is no direct evidence that MMS improves cosmesis compared with SE (Brown AC, Brindley L, Hunt WTN et al. A review of the evidence for Mohs micrographic surgery. Part 2: basal cell carcinoma. Clin Exp Dermatol 2022; 47:1794–804). Cosmetic and functional outcomes are usually only relevant in high-risk sites (e.g. the central face H zone) and in certain high-risk tumours where wide local excision would be the alternative treatment. In conclusion, we propose that PILs in MMS should avoid using misleading language like ‘thin’ and ‘small’ when describing the procedure. Patient information leaflets should clarify that the vast majority of tumours are cleared after two stages rather than requiring multiple stages. Tissue sparing should not be highlighted as the main advantage of MMS, and patients should not be pledged small wounds and better cosmetic outcomes.

О развитии компетентностной модели квалификационной аттестации аудиторов в условиях импортозамещения

The article presents the results of the audit competency monitoring conducted in the first half of 2023. The generalized results of monitoring all groups of respondents showed that the ongoing transformation of the profession requires an increase in the level of competencies in the field of IT, business analysis, audit procedures to ensure users' confidence in the reliability of financial and non-financial information based on international auditing standards and national legislation in this area of professional activity.

Comments of the AFAANZ Auditing and Assurance Standards Committee on Proposed International Standard on Auditing 500 (Revised) Audit Evidence

AbstractThe International Auditing and Assurance Standards Board (IAASB) issued for public comment Proposed International Standard on Auditing 500 (Revised) Audit Evidence. The Australian Auditing and Assurance Standards Board (AUASB) and New Zealand Auditing and Assurance Standards Board (NZAuASB) also called for comments. The Auditing and Assurance Standards Committee of AFAANZ prepared a submission, based on the findings reported in extant research, responding to a number of the questions asked by the IAASB (and AUASB/NZAuASB). This technical note presents the formal submission made to the IAASB.

P26 Epidemiology and risk factors associated with and clinical approach to Staphylococcus aureus bacteraemia at North West Anglia Foundation Trust (NWAFT)

Abstract Background Staphylococcus aureus bacteraemia (SAB) is associated with high mortality and morbidity. Certain patient groups are predisposed to developing SAB. Careful monitoring of these patients for persistence of bacteraemia and development of complications is important to improve prognosis. There is international consensus on (i) treating patients with at least 2 weeks of IV antibiotics, (ii) performing echocardiography to evaluate for infective endocarditis and (iii) repeating blood cultures 2–4 days after initiating empirical treatment. Adherence to trust antimicrobial guidelines is also imperative to national antimicrobial stewardship. Objectives To characterize patients at risk of SAB and make recommendations to reduce the incidence and complications of SAB. Methods Retrospective review of case notes of patients whose blood culture results were positive for S. aureus from April to September 2022 in NWAFT. 57 results from 51 patients aged 0 to 96 years were included. The four audit standards were compliance with (i) trust empirical antimicrobial guidelines, (ii) 2-week duration of IV therapy, (iii) echocardiography evaluation for endocarditis, and (iv) repeat blood cultures 48–96 hours after initiating empirical treatment. Patients who were on palliative pathway were excluded from analysis of standards two to four. Prognostic outcomes were examined in terms of hospital readmission, recurrence and mortality. Results 36 patients (70.6%) were found to harbour known risk factors, with the presence of indwelling prosthetic devices (83.3%) and type 2 diabetes (25.0%) being the most common. The most frequent sources of infection were unknown (27.5%) as well as the skin or soft tissue (17.6%). MRSA bacteraemia accounted for 10.5% of all cases. The compliances with (i) trust empirical antimicrobial guidelines, (ii) 2-week duration of IV therapy, (iii) echocardiography evaluation of endocarditis and (iv) repeat blood cultures 48–96 hours after initial blood culture were 52.8%, 75.0%, 57.8% and 66.0%, respectively. Rates of hospital readmission, recurrence and mortality were 39.5%, 11.4% and 35.3%, respectively. Conclusions The incidence of SAB correlates with the presence of risk factors, and SAB is associated with adverse outcomes. There was partial compliance with the audited outcomes. Introduction of trust SAB guidelines to guide clinical approach and adherence to local antimicrobial prescribing guidelines are imperative to improving patient outcomes.