9.  LOCAL OPTION QUESTION

Areas and facilities have the ability to formulate their own supplemental audit question, if desired. This permits each Area to analyze an additional aspect of diabetes care that may be of special interest, or to "test run" a question that might be a useful future addition to the national diabetes audit. The procedure for developing and incorporating a local option question is explained below. Although separate facilities within an Area may not necessarily be required to use the same question, it is highly recommended that this be discussed and coordinated with your Area Diabetes Consultant.

If you elect to add a Local Option question, the first step is to develop a question that can be answered through a review of individual medical charts. The question can relate to demographics (Indian blood quantum, location of residence, etc), a particular aspect of care (examinations, lab studies, other medications, and so forth), co-morbid condition (history of stroke or MI, for example), a clinic related parameter (such as the number of visits in the preceding month or year), or other auditable element of interest.

The local option question needs to be posed in multiple choice format. The choices may be as simple as 'Yes' or 'No', or may have many possible answers. There can be up to 9 choices, although for ease of answering and reporting it is usually best to limit choices to no more than 4 or 5. Each choice needs to have an assigned number, just like other parts of the audit.

After the question and response choices are formulated, print or type them onto the lower righthand side of the audit form. If there is insufficient room, a separate sheet can be stapled to the audit form. Be sure to precede each choice with its associated one-digit number.

Data entry for a local option question is easy. A special "Local Option" field is provided at the very end of the audit, and is clearly identified on the data entry screen. Responses from the audit form can be entered there in the same manner as all other data is entered.

Modifying the Report File

In order for the results of the local option question to appear in the final printed report, it must be included in the report file (AUDIT07.RPT). To do this, first assure that all the AUDIT07 files are loaded into the Epi Info subdirectory (if necessary, refer to next section for directions). Then use the following steps to place the local option question into the report file:

1. From Epi Info's main menu, press <F3> (Open). An "Edit a file" box will appear and prompt you for a Name. Type AUDIT07.RPT <ENTER>. The AUDIT07.RPT file will appear.

2. Press the <Page Down> key 9-10 times, or use the down-arrow key to get to the last part of the AUDIT07.RPT file. You will see the line *#USES LOCAL. Delete the asterisk (*), and only the asterisk,  from the beginning of the line.

3. Immediately below the #USES LOCAL line, substitute your question for the sample question, being careful not to go beyond mid-page. Use multiple lines if necessary. Delete the asterisk (*) from the beginning of each line that you use.

4. Type in each of the possible responses, again substituting for the sample answers. Be sure to delete the initial asterisk (*), but only on the lines that are actually used. Lines with an initial asterisk remain "invisible" when printing the report (If you wish, any extra lines may be deleted by placing the cursor anywhere on the line and pressing <CTRL> - y).

5. Check the alignment of the bracketed numbers to the right of the responses. Add or delete spaces until the first brackets of the bracketed numbers line up in a vertical column.

6. Press <F9> to save these changes, then <F10> to return to the main menu.

7. The report file has now been modified to give the results of your local option question. Enter your audit data if you have not already done so (refer to section 11), "clean" your data (optional, see section 11) and then print your customized summary report(s) (sections 12 - 15).