Bookmarkers beware: Bookmarks to pages other than the home page may not work after we change our server in April Editor's Choice | This Week in BMJ | Press releases BMJ No 7129 Volume 316 Letters Saturday 7 February 1998 Electronic record linkage to create diabetes registers Impressive results can be obtained without record linkage Editor, Morris et al have shown a gold standard method of compiling a community based diabetes register using record linkage of multiple data sources.(1) They conclude that this method was `more sensitive than general practice registers in ascertaining cases of known diabetes.' We question the subliminal message in their paper - that with a diabetes register created from data from hospital clinics and general practices alone, effective diabetes care could not be delivered and outcomes monitored as outlined in the targets of the St Vincent declaration.(2) Using general practice registers and the hospital clinic register in the Borders region of Scotland, we have identified 2067 live patients in the area from a total population of 106,000 (point prevalence 1.95%). We believe that we have achieved this quality of data collection by means of anonymised feedback of the prevalence of diabetes and other indicators to each practice annually. Between 1995 and 1996 this resulted in an increase in the number of known patients with diabetes from 1,825 to 2,067; seven of 24 practices in the area have a prevalence of diabetes of over 2%, and in one practice the prevalence is 3.5%. The recording of retinopathy screening improved from 58% in 1995 to 86% in 1996. For those patients attending only general practice diabetic clinics the mean haemoglobin A1c concentration fell from 8.92% in 1995 to 6.92% in 1996. When these data were analysed further 408 sets of paired data were identified, and in these patients the haemoglobin A1c fell from 7.25% in 1995 to 7.00% in 1996 (P<0.0001). Our experience suggests that active participation in and ownership of a diabetes register between hospital clinics and general practices can achieve equally impressive results. We would encourage district diabetologists and general practitioner colleagues to continue to refine their data collection on these patients and not to be discouraged by the lack of electronic record linkage or sophisticated monitoring facilities. Peter J Leslie Consultant physician Sheena McDonald Audit facilitator Ian A McDonald Director, public health medicine On behalf of the Borders diabetes register Borders General Hospital, Melrose, Roxburghshire TD6 9BS References 1 Morris A D, Boyle D I R, MacAlpine R, Emslie-Smith A, Jung R T, Newton R W, et al for the DARTS/MEMO Collaboration. The diabetes audit and research in Tayside Scotland (DARTS) study: electronic record linkage to create a diabetes register. BMJ 1997;315:524-8. (30 August.) 2 World Health Organisation (Europe), International Diabetes Foundation (Europe). Diabetes care and research in Europe: the St Vincent Declaration. Diabetic Med 1990;7:360. Home | Current issue | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline