I trust it completely. I'm just overly-paranoid!
But in all seriousness, I always review any changes it makes since I'm on the computer pretty much every day after it finishes. I just know a lot of people who don't like me very much and love screwing with me, so it's kind of a "better safe than sorry" scenario for me. Avast! has saved my *** a few times thanks to that.
The eight active scanning modules are sufficient protection for me and my purposes. Every time one of them blocked, intercepted, quarantined, a malicious file was prevented from running at that moment in time on my system. Prevention is key here, not forensic cleansing after the fact. I leave the tedious bits of cleaning to the likes of essexboy and others. Full and quick scans are pretty much useless for me, as most detections are not for live and active malware; the only part not covered by active scanning is that of rootkits and such. These are so rare, it is not worth the time and wear and tear on the system to run them, as it is mostly a waste of time to conduct such a search.
Is being proactive better than being reactive? In the case of running and using Avast!, the answer would be no. Active shields protect by preventing malicious action; system cannot be infected if malicious agent cannot run on it, same as if Windows was a Linux system, same strategy here.
No change in operative behavior from day to day means no infection. Malware infections almost always cause changes in booting, calling and running third-party programs, system crashes, BSOD'S, etc. There can be other causes, such as hardware issues, but if you have been hit by a malware infection, yesterday's clean scan result will be no help for you whatsoever today.