Letters5 September 2006Poorly Controlled Cardiovascular Risk Factors and ICD-9-CM CodesNicolas Rodondi, MD, MAS, Eve A. Kerr, MD, MPH, and Joe V. Selby, MD, MPHNicolas Rodondi, MD, MASFrom University Outpatient Clinic, University of Lausanne, 1011 Lausanne, Switzerland; Ann Arbor Veterans Affairs Center for Practice Management and Outcomes Research and University of Michigan Medical School, Ann Arbor, MI 48113; and Kaiser Permanente, Oakland, CA 94612.Search for more papers by this author, Eve A. Kerr, MD, MPHFrom University Outpatient Clinic, University of Lausanne, 1011 Lausanne, Switzerland; Ann Arbor Veterans Affairs Center for Practice Management and Outcomes Research and University of Michigan Medical School, Ann Arbor, MI 48113; and Kaiser Permanente, Oakland, CA 94612.Search for more papers by this author, and Joe V. Selby, MD, MPHFrom University Outpatient Clinic, University of Lausanne, 1011 Lausanne, Switzerland; Ann Arbor Veterans Affairs Center for Practice Management and Outcomes Research and University of Michigan Medical School, Ann Arbor, MI 48113; and Kaiser Permanente, Oakland, CA 94612.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-145-5-200609050-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE: We agree that it is difficult to accurately capture disease severity and control with commonly used ICD-9 classifications. For this reason, we used ICD-9-CM codes, along with ambulatory blood pressure measurements, laboratory results, and prescriptions, to identify the presence of hypertension, dyslipidemia, and diabetes mellitus but not to grade their degree of severity or control. As described in our Appendix Table 2 and in our Methods section, we used actual ambulatory blood pressure measurements and laboratory results from the electronic records at Kaiser Permanente to define control and pharmacy records to identify medication intensification. Previous studies have documented ...