[Pilot study of controlled retrospective analysis (retrolective study design) of care for type 2 diabetics since 1990].
OBJECTIVE
There are few data on the quality of care received by patients with type 2 diabetes under routine conditions and only a few long-term studies that investigated the influence of treatment strategies on the development of clinical endpoints. It was the aim of this study, using retrospectively obtained data, to determine whether it is possible to document over a 10 year period the treatment design and clinical end-points in type 2 diabetics under the care of general practitioners.


METHODS
General practitioners were randomly selected and informed by independent collaborating monitors about the aim of the study and data documentation. At a second visit by a monitor the completed data forms were audited and entered into a database. Course of treatment was documented by 21 general practitioners, two of them diabetes specialists, for all patients in whom, between 1.1.1990 and 31.12.1993, type 2 diabetes had been diagnosed for the first time (n=455; 251 females, 204 males, mean age 61,5 years). Continuous complete documentation of the course of treatment in the given practice was obtained in 85% of patients over a mean observation period of 8,7 years. 45 myocardial infarcts in 40 patients (9%), 42 strokes in 37 patients (8%), blindness in seven eyes of five patients (1,5%) and 19 amputations (4,2%) were recorded; 72 patients died (15,8%).


CONCLUSIONS
The data of this pilot study indicate that detailed analysis of treatment quality can be obtained in a sizeable cohort, using of a well controlled retrospective (retrolective) study design.
Martin
S
S
Deutsche Diabetes-Klinik, Deutschen Diabetes-Forschungsinstitut, Leibniz-Institut an der Heinrich-Heine-Universität Düsseldorf. martin@ddfi.uni-duesseldorf.de
Reipen
M
M
van Leendert
R
R
Beuth
J
J
Kolb
H
H
Scherbaum
W A
WA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D000792:Angiography / Q000706:statistics & numerical data; D001766:Blindness / Q000453:epidemiology / Q000209:etiology; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000401:mortality / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000209:etiology; D017719:Diabetic Foot / Q000453:epidemiology / Q000209:etiology; D004282:Documentation; D005194:Family Practice / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D010865:Pilot Projects; D011787:Quality of Health Care; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology / Q000209:etiology