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ACP does not support “Diabetes Screening for People with Schizophrenia or Bipolar Disorder who are Using Antipsychotic Medications” for use at the health plan level because of uncertain validity. Given that antipsychotics place patients at an increased risk for diabetes and cardiovascular disease, physicians should screen for diabetes in such patients. However, broader diabetes screening measures will capture this subset of patients. The developer cites evidence from patients who are overweight to form the basis of the performance measure, while the measure applies to all patients with schizophrenia or bipolar disorder taking antipsychotic medications. A side effect of some antipsychotics include weight gain, but that does not apply to all medications. Measure specifications should include all patients taking antipsychotics that increase diabetes risk and exclude patients with limited life expectancy and increased fragility. The developers should also consider revising the specifications to exclude medications that do not increase the risk of diabetes in patients with serious mental illness.