TY - JOUR T1 - How much monitoring? JF - British Journal of General Practice JO - Br J Gen Pract SP - 350 LP - 351 VL - 57 IS - 538 AU - Paul Glasziou Y1 - 2007/05/01 UR - http://bjgp.org/content/57/538/350.abstract N2 - Variations in practice can alert us that a problem exists, but do not tell us what to do. As practitioners we can be consistent but wrong (as with hormone replacement therapy), or inconsistent but without important impacts (as with choice of antipyretic to treat fever). Although inconsistencies are imperfect markers, they do demand examination in practice. In this issue, Vinker and colleagues1 show considerable difference in the number of tests ordered by practitioners in Israel over a single year. A fourfold difference was found between locations in the rates of some testing.1 But are practitioners who are doing more haemoglobin A1c (HbA1c) tests, or those doing fewer tests, practising more appropriately? Those wanting to reduce costs may push for the lower rates, but this should only be acceptable if that were also clinically appropriate. Unfortunately, for many of the common tests examined by Vinker et al the poor development of our research base in diagnostics does not … ER -