At baseline (2008-9), 135 NPCSs were identified in Kenya, Tanzania and Malawi, among whom 133 were located and 129 (97%) completed the forms, thereby enrolling in the study (Kenya 88, Tanzania 38, and Malawi 3).
In particular, we only included patients who were continuously enrolled, thereby limiting the generalizability of our study to continuously enrolled managed care patients with diabetes.
Strengths of the present study include daily screening for consecutive eligible patients to be enrolled, thereby minimizing the potential for selection bias.
Instead, this study demonstrated a nonsignificant 6% difference in mortality (34% for subjects receiving norepinephrine and dobutamine compared to 40% for subjects receiving epinephrine), similar to mortality reduction seen with activated protein C. Second, a large number of subjects (1261/1591) screened for the study were not enrolled, thereby limiting the generalizability of the study.
Firstly participating centres were at liberty to decide which patients they would enrol; subjects were not, therefore, enrolled consecutively, thereby introducing a potential for selection bias.
Of these, only 50%to60%0% are currently enrolled [ 12], thereby reducing the population coverage even further.
The older plans would be left with a relatively sicker population, forcing them to raise premiums for everybody still enrolled in them and thereby encouraging more healthy people to leave ― until, eventually, those plans had shrunk to small groups of people with big medical problems.
The strength of our study is that we had an ethnically homogenous and well phenotyped diabetic subjects enrolled from a single centre, thereby reducing phenotyping errors and bias.
Second, previous studies that compared βb with other antihypertensive agents typically enrolled fewer than 100 women, thereby lacking adequate statistical power to address rare but important adverse perinatal events, including perinatal mortality [ 5].
On the health system's part, this may happen when the health system's capacity is not matched with increasing treatment coverage, thereby shifting clinical focus to the newly enrolled patients or those in need of immediate attention.
