0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

A Counterargument to Encounter Frequency and Target Achievement: Measurement Variability

Andrew Hayen, MBiostat, PhD; Katy Bell, MBBCh, PhD; Paul Glasziou, FRACGP, PhD; Les Irwig, MBBCh, PhD
Arch Intern Med. 2012;172(4):374-375. doi:10.1001/archinternmed.2011.807.
Text Size: A A A
Published online

Extract

We offer an alternative explanation for the conclusion of the recent report by Morrison and colleagues1 that encounter frequency leads to apparent better control of glucose (hemoglobin A1c), blood pressure, and low-density lipoprotein cholesterol in patients with diabetes mellitus. While the authors have acknowledged that several forms of bias (including confounding) may affect their results, another important reason for the association between more frequent consultations and meeting targets is measurement variability. Each marker is subject to considerable random measurement variability.24 Because of random “highs,” those with more frequent measurements will more likely be mistakenly labeled as being uncontrolled. The exclusion of patients with “transient” highs partly mitigates this problem. Patients with borderline levels who have more frequent physician encounters are still more likely to be identified as uncontrolled compared with those with less frequent encounters.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

February 27, 2012
Fritha Morrison, MPH; Maria Shubina, ScD; Alexander Turchin, MD, MS
Arch Intern Med. 2012;172(4):374-375. doi:10.1001/archinternmed.2011.1414.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();