Abstract
In this study, we attempted to clarify the problem of discrepancies in interpretation of “good control” in treatment courses of diabetes among specialists in this disease by means of a researod technique never applied before. Data covering two-year treatment courses along with background factors from 279 patients with diabetes type II up to a moderate disease state who were on diet therapy alone or under additional treatment with hypoglycemic agents were submitted to each of the specialists in diabetes (9 persons), who were asked to evaluate the treatment conditions of each case in terms of satisfactoriness. The applied rating scale consisted of a contrasting “satisfactory-unsatisfactory” pair with continuous grading in between. The data from these ratings were then subjected to multivariate analysis and their relation to the examiners was also analyzed. The results showed that the specialists could be roughly divided into two groups: one showing a similarity in preference of items and the other providing similar distances (mildness or severity) of satisfactoriness rating. Out of eight specialists, three belonged to the first group and showed, at the same time, similar “distances”. These three belonged to different institutions than the rest of the examiners and had different clinical experiences. This demonstrates differences of evaluation standards even among specialists. Standardization was therefore felt necessary in evaluating good or poor control of diabetes. For the progress of diabetes treatment in the future, in our opinion, great importance must be placed on continued efforts to determine the goodness or poorness of diabetes control by collecting more data on clinical courses and at the same time by accumulating prognostic information in the long term.
