Targets set reference points for clinic comparisons

EDITOR,--Chris Butler and colleagues show impressively how systematic collection and use of case based information can help identify problems in the search for improved quality of care in diabetes.1 Pointing to the difficulties with setting targets in the treatment of diabetes and in its care, they argue that targets for haemoglobin A1 concentration may be set more on an idealistic than on a realistic basis. They also argue that inappropriate targets, in many instances, may do more damage than good to the ultimate goal of reducing morbidity and mortality through improved metabolic control.

A central question about setting targets is whether they should be “visionary” or attainable by a certain proportion of the people concerned. On …