Such patient records provide detailed clinical information, however, they may be incomplete and contain misclassifications. Especially, tests and drugs prescribed by specialists in the hospital can be missed. Since we included only patients who are primarily managed by their general practitioner, this will be uncommon for our study population. Furthermore, dates of tests in patient records may be imprecise, either reflecting the date when the test was performed or the date when the result was received in the practice. This was taken into account by defining prompt reaction to testing as any action within a period of 30 days. In CYT387 1056634-68-4 conclusion, looking at the overall pathway of risk factor management in diabetes significantly lowers estimates of quality as compared to the assessment based on commonly used simple process measures. Our study showed that this reduction is mostly driven by lack of treatment intensification for all risk factors. Based on our findings from clinical practice, a period of 12 months may be too short for assessing annual testing of risk factors such as cholesterol and albuminuria. For assessing intensification of treatment and response to treatment, it seems reasonable to allow for the next routine diabetes visit. Extension of the time periods for quality assessment up to half a year did not significantly influence the quality estimates. n. To the best of our knowledge, this is the largest meta-analysis so far to investigate the association of eNOS three common polymorphisms with hypertension from the English and Chinese-published literature. To avoid the disturbance of publication bias, we divided studies into characteristic-homogeneous groups such as the published language, and this situation has been greatly improved. For example, association of G894T polymorphism with hypertension showed high probability of publication bias in overall analyses, whereas none was observed in published language-stratified subgroups. At this point, we interestingly found remarkable heterogeneous associations by showing null association of 894T allele with hypertension in WIE studies, which was consistent with the results of two previous meta-analyses. Contrastingly, in this study, 894T allele carriers had a 52% increased risk in WIC studies, and a 40% and 32% increased risk, while suffering significant heterogeneity and publication bias, in Chinese and Asian populations, respectively. However, this association exhibited no significance in Whites, suggesting the heterogeneous associations of G894T polymorphism in ethnicityspecific populations. In view of this divergence, it is highly suggested to construct a database of polymorphisms related to hypertension in each racial or ethnic group. Although linkage information was lacking for eNOS, two previous powerful meta-analyses indicated positive signals between eNOS variation and hypertension by consistently predisposing 4b allele to an increased risk, although publication bias obscured each study, which was in agreement with our overall estimates. Although the influence of publication bias was ‘artificially’ curbed in this study, existence of heterogeneity still toggled most comparisons.