Background and aims Clinical audit is a process that has been defined as ’a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change’. This study was undertaken to evaluate the quality of explicit audit criteria in published paediatric audits.

Methods The PUBMED, MEDLINE and CINAHL databases were searched for paediatric audits published in English using a combination of key words and MeSH headings between the years 2007–2015. Each article was reviewed by 2 authors and if a disagreement occurred the article was reviewed by at least 3 authors. The quality of the standards used in the audits was evaluated utilising the Oxford Centre for the Evidence-based Medicine Levels of Evidence (March 2009).

Results Seven hundred and thirty-two articles were identified and 730 were retrieved. Two articles were excluded as they were ‘not healthcare related’ and did not deal with a predominant paediatric population. Ninety three percent (677 articles) were classified as ‘reviews of practice’. Of these 214 articles (29%) had a defined standard. Only 84 (11%) fulfilled the criteria of an audit (Fig.1). Fifty two percent of audits were from the UK.

Thirty-four (40%) audits used standards of high quality of evidence (1a-1b). Those were mostly international or national guidelines. Thirty-seven percent standards were based on the ‘expert opinion’ (level 5).

Conclusions Only 11 percent of studies described as ‘audits’ fulfilled the actual definition of an audit. Prior to undertaking audits clinicians should evaluate the quality of the standards that they intend to use. The increasing numbers of evidence based guidelines should make this process easier.