Can clinical audits be enhanced by pathway simulation and machine learning? An example from the acute stroke pathway

NHS England describes clinical audit as a way of identifying whether healthcare is being provided in accordance with agreed standards and where improvements could be made to improve outcomes for patients.1 Audits may be local or national. In England the Healthcare Quality Improvement Partnership (HQIP), on behalf of the National Health Service (NHS), is responsible for overseeing and commissioning more than 30 clinical audits, which form the National Clinical Audit Programme.2 These collect and analyse data supplied by local clinicians. The national audit covering stroke is the Sentinel Stroke National Audit Programme (SSNAP).3 Stroke is a leading cause of death and disability worldwide, with an estimated 5.9 million deaths and 33 million stroke survivors in 2010.4