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The Role of Clinical Uncertainty in Treatment Decisions for Diabetic Patients with Uncontrolled Blood Pressure
- Eve A. Kerr, MD, MPH;
- Brian J. Zikmund-Fisher, PhD;
- Mandi L. Klamerus, MPH;
- Usha Subramanian, MD, MS;
- Mary M. Hogan, PhD, RN; and
- Timothy P. Hofer, MD, MS
- From the Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, and the University of Michigan Department of Internal Medicine, Ann Arbor, Michigan, and Roudebush Veterans Affairs Medical Center and Indiana University, Indianapolis, Indiana.
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Figure 1. Hypertension clinical action model. -
Figure 2. Study flow diagram.PCP = primary care provider. *Diabetic patients presenting for a primary care visit to 1 of 92 participating providers were referred for eligibility assessment if their lowest triage blood pressure was ≥140/90 mm Hg. *Number of responses varied by individual item.
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Figure 3. Relationship of systolic and diastolic blood pressures at enrollment and mean previous year systolic blood pressure with probability of treatment change.Each curve is shown with the other 2 blood pressure components adjusted to their mean value and the intensification rate for the average provider and clinic site. For each blood pressure component, the curve is presented only for a range of values actually seen when the other 2 components are both close to their mean (±10 mm Hg of the mean value).
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