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COMMENTS AND OPINIONS
The Impact of the ABIM’s Practice Improvement Modules on Patient Outcomes
Maureen Murdoch, MD, MPH
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In the article titled, "Improving Asthma Care Through Recertification: A Cluster Randomized Trial," the authors argue in the "Comment" section that their findings "provide the first evidence" that the recertification requirements of the American Board of Internal Medicine (ABIM) "may improve relevant disease outcomes."1(p2243) However, the authors base this statement on a post hoc analysis of a highly selected subsample (patients assigned to physicians who fully completed the ABIM's asthma practice improvement module [PIM]) using an "end point" that was not specified at the time they registered their clinical trial. Even then, the so-called improvement was of questionable clinical significance. Using a more appropriate intention-to-treat analysis that compared the patients of physicians assigned to usual practice or to the completion of the PIM, the authors found no clinically important or statistically significant difference in their primary outcome (ie, percentage of physicians' patients filling an inhaled corticosteroid . . . [Full Text of this Article]
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RELATED ARTICLE
Improving Asthma Care Through Recertification: A Cluster Randomized Trial
Jan Simpkins, George Divine, Mingqun Wang, Eric Holmboe, Manel Pladevall, and L. Keoki Williams
Arch Intern Med. 2007;167(20):2240-2248.
ABSTRACT
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RELATED LETTER
The Impact of the ABIM’s Practice Improvement Modules on Patient Outcomes—Reply
Jan Simpkins, George Divine, Mingqun Wang, Eric Holmboe, Manel Pladevall, and L. Keoki Williams
Arch Intern Med. 2008;168(16):1827.
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