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Atrial Fibrillation — UKMLA MCQ

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MediumCardiologyAtrial FibrillationUKMLAMRCGP AKTPARAMRCP Part 1PSA

In the baseline audit, 126 of 180 eligible patients met a standard. A re-audit initially recorded 167 successes among 210 patients. Validation then found that 7 of the 210 were ineligible and that 5 of those 7 had been counted as successes. The target is a relative improvement of at least 15% from baseline. After correcting the re-audit data, what is the minimum number of additional eligible patients who would have needed to meet the standard for the target to be reached, assuming the corrected denominator remains fixed?

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Correct answer: B — 2 additional patients

Baseline performance is 126 ÷ 180 = 70%. A 15% relative improvement requires 70% × 1.15 = 80.5%. Correcting the re-audit removes 7 patients and 5 successes, giving 162 of 203. At least 0.805 × 203 = 163.415 successes are required, so the whole-number threshold is 164. Two additional successes are therefore needed; B is correct. One additional success in A gives 163 of 203, or 80.30%, which remains below the 80.5% target. C, D and E would all exceed the target, but none is the minimum number required because the threshold has already been crossed with two.

Reference: NICE, Audit and service improvement: https://www.nice.org.uk/about/what-we-do/into-practice/audit-and-service-improvement