Translating Medical Science Into Medical Practice

Abstract

As medical therapy becomes ever more effective, the need to make the fruits of scientific progress available to all who need them becomes increasingly more urgent. One way is to establish guidelines or standards for provision of services of proven value and to monitor compliance with those recommendations. In their carefully done and provocative study of ambulatory testing in Medicare patients, Weiner et al 1 provide disturbing evidence of a substantial shortfall in the provision of several key diagnostic tests for monitoring patients with diabetes mellitus. See also p 1503. The use of claims data to assess quality of care has been repeatedly criticized, primarily because of its lack of clinical detail and inaccuracies in coding. While these deficiencies limit the usefulness of claims data for evaluating outcomes such as mortality and complications, they are less relevant here because the authors have confined their analysis to the question of whether