Please select the eligibility criteria that correspond to the clinical trial below.
Title: Patient Based Strategy to Reduce Errors in Diabetes Care
Brief Summary: This project evaluates a HPMG effort to reduce error rates through customized direct feedback of diabetes quality of care data to diabetes patients and their physicians. HPMG has routinely provided patients with personalized feedback of glucose and cholesterol test results since about 1997. This project will implement and evaluate the impact of this intervention on diabetes medical error rates and resource use.


Options:
A: Inclusion Criteria:

* Colorectal cancer before the age of 50 years
* Second colorectal cancer at any age
* Colorectal cancer and other HNPCC associated extracolonic cancer irrespective of age at diagnosis
* Adenoma with high grade dysplasia diagnosed before the age of 40 years
B: Inclusion Criteria:

Hospital: Treat \> 30 AMI/CHF cases/patients per year in Ontario

Patient:

* AMI Most responsible diagnosis of acute myocardial infarction(ICD-9 code 410)
* CHF Most responsible diagnosis of heart failure(ICD-9 code 428)

Exclusion Criteria:

Patient

* AMI Not admitted to an acute care hospital
* AMI Age \< 20 or \> 105 years
* AMI Invalid health card number
* AMI Admitted to non-cardiac surgical service
* AMI Transferred from another acute care facility
* AMI coded as an in-hospital complication
* AMI admission within the past year
* CHF Not admitted to an acute care hospital
* CHF Age \< 20 or \> 105 years
* CHF Invalid health card number
* CHF Admitted to surgical service
* CHF Transferred from another acute care facility
* CHF coded as an in-hospital complication
* CHF admission within the past three years
C: Inclusion Criteria:

* For physician intervention inclusion criteria included; 1)primary care (general internist or family) physician in HealthPartners Medical Group. 2)Provided ongoing care to 20 or more adult patients with diabetes.
* For patients inclusion criteria included; An established diagnosis of diabetes based on either (a) two or more ICD-9 diagnosis codes for diabetes in a 12-month period of time, or (b) a filled prescription for a diabetes-specific drug within a 12-month period of time.

In addition, participating patients met all of the following criteria: (a) age less than 75 years, (b) Charlson comorbidity score of 3 or less, (c) linked to the a primary care physician who was participating in the study in two consecutive calendar years, (d) had pharmacy coverage at the time of the intervention and for the previous 12-month period, and (e) had either HBA1c \> 7% or LDL \> 130 mg/dl (or LDL \> 100 mg/dl if the patient also had CHD).

Exclusion Criteria:

* none
D: Inclusion/exclusion criteria are based on practice characteristics. Practices are considered the study participants. However, because of the individual nature of the intervention tool, individual healthcare providers in the participating practices will be asked to participate voluntarily in the intervention and data collection. We anticipate approximately 320 healthcare providers to be included in these 64 practices. The research study will not directly intervene on patients of participating healthcare providers. However, patient charts will be assessed to evaluate changes in the practice's screening and management behaviors. Patient records will be included in this project in proportion to patient representation in participating primary care practices in NC and in proportion to their rates of cholesterol screening.

Potentially eligible patients for the chart abstraction sample will be adults, ages 21 through 84 years, seen in the participating primary care practices during the baseline (July 1, 2001 - June 30, 2003) or follow-up (March 1, 2004 - February 28, 2006) periods. We are examining two-year periods to increase the proportion of patients that has been screened. We can include "year 0" (July 1, 2001 - June 30, 2002), because ATPIII was published in May 2001. Although the guidelines do not exclude persons older than 84 years, at present we propose to restrict the evaluation sample to the aforementioned age group, due to acknowledged controversies regarding the appropriate preventive strategies in the very old.

Practice Inclusion Criteria:

Primary Care Practices (Internal Medicine or Family Medicine) Within 3-hour driving radius of WFUSM At least 50% of practice's providers willing to participate in study Willingness to accept randomization assignment Willingness to participate in chart audit Have a computer suitable for connectivity with the PDAs for installation of software upgrades and for printing of patient-specific reports for medical record documentation purposes

Practice Exclusion Criteria:

Academic practices

Provider Inclusion Criteria:

Practicing healthcare provider affiliated with a primary care practice participating in GLAD Heart.

Willingness to participate

Provider Exclusion Criteria:

None

Potentially eligible patients for the chart abstraction sample will be adults, ages 21 through 84 years, seen in the participating primary care practices during the baseline (July 1, 2001 - June 30, 2003) or follow-up (March 1, 2004 - February 28, 2006) periods. We are examining two-year periods to increase the proportion of patients that has been screened. We can include "year 0" (July 1, 2001 - June 30, 2002), because ATPIII was published in May 2001. Although the guidelines do not exclude persons older than 84 years, at present we propose to restrict the evaluation sample to the aforementioned age group, due to acknowledged controversies regarding the appropriate preventive strategies in the very old.

Answer: C