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This lack of documentation may be due to the fact that patient involvement is seen more as an end in itself, rather than a means, and to the difficulty of evaluating their involvement without the support of widely accepted frameworks and tools [ 14].
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When we examined urine protein testing in the diabetes subgroup, we did not see an association with CKD documentation, which may be due to competing demands in patients with multiple comorbidities [ 28].
Finally while there were differences seen in the percentages of documentation of risk factors, this may be due mainly to test indication, whereby certain tests such as cholesterol levels are more likely to be ordered on most patients than fasting glucose.
Some of the higher precisions we calculated for the original Cochrane reviews investigated in this work may be due to documentation issues (Additional file 2).
However, this may be due to non-documentation and the real figure is probably higher.
This discrepancy from the study of Pirkle et al. [ 29] may be due to the poor documentation and consequently incorrect provisional diagnosis.
Family medicine providers were more likely to use structured documentation compared to their internal medicine counterparts, and may be due to differences in the way different specialties interact with the EHR.
A possible bias may exist in the interpretation of the measured effect, which may be due to greater accuracy of documentation rather than to a real change in care.
This may be due to a lack of documentation, sufficient research, application of available research for planning [ 173], or to the genuine lack of effective eye care interventions at primary level.
This may be due to variations in practice based on differing requirements, documentation systems and terminology across locations and clinical situations [ 17].
This may be due to under-detection, under-recognition or under-documentation of HIV infection during delivery.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com