A recent review by the American College of Physicians (ACP) found that most existing performance measures for diabetes care do not meet high-quality standards. Out of 14 key measures, only four were found to be methodologically sound and evidence-based, highlighting a significant gap in how diabetes care is currently evaluated and reported.
Why Measuring Diabetes Care Matters
Diabetes is one of the most common and serious chronic diseases, affecting millions and leading to significant health complications. Effective and timely management is crucial to reducing the disease’s impact. Many healthcare systems rely on “performance measures”—standards that help track and improve the quality of care—to guide diabetes treatment and follow-up.
Key Findings from the Review
The ACP’s Performance Measurement Committee (PMC) looked closely at 14 widely used performance measures for diabetes. Their review focused on screening, glycaemic (blood sugar) control, and monitoring related conditions (comorbidities). Importantly, only four of these measures were found to meet the ACP’s strict criteria for scientific validity, clinical relevance, and usefulness.
The measures that did pass muster include:
- Kidney health evaluation
- HbA1c (blood sugar) control
- Regular eye examinations
- Use of ACE inhibitor or ARB therapy (medications that help protect the kidneys)
The rest—nearly all the others evaluated—were considered inadequate or not robust enough to be reliably used for accountability, payment, or public reporting.
What This Means for Patients and Providers
This review highlights a critical challenge: many of the tools currently used to assess and improve diabetes care may not be scientifically trustworthy. While performance measurement is an important way to drive quality in healthcare, this study shows that there’s a real need to improve and standardize these measures. Only by using solid, evidence-based standards can we ensure that patients receive the best possible care.
Conclusion
While progress has been made in diabetes research and management, the way we measure quality of care needs a significant upgrade. The ACP’s review is a strong call for better, more reliable ways to track and improve diabetes care for millions of Americans.
Paper details: This review, titled "Quality Indicators for Diabetes in Adults: A Review of Performance Measures," was authored by the American College of Physicians Performance Measurement Committee. It was published in the Annals of Internal Medicine.
