Dictionary of Evidence-based Medicine.pdf

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Dictionary of Evidence-based Medicine 109 Neoclassical economics Neoclassical economists built on the work of Adam Smith (classical school) and claimed that market forces were strong enough to overcome economic shocks and move back to equilibrium without government intervention. Society, they argued, has a natural social order. The neoclassical vision was much favoured until the great depression of the 1930s when the world economy plunged into deep depression and unemployment reached record levels. Despite this apparent failure of the neoclassical vision, many modern economists in fact call themselves neoclassicals. Net national product (NNP) (see under Gross domestic product) NHS (National Health Service) The NHS is the organization which provides health care to the United Kingdom population. It was set up immediately after the Second World War to provide a comprehensive health service for all. 'Comprehensive' was defined as 'available to all people' and covering 'all necessary forms of care'. Despite a number of reforms, the system has operated successfully for over five decades (DoH (1946) A national health service. Cmd 6502. HMSO, London. DoH (1997) The new NHS. Cmd 3807. HMSO, London). NHS Executive The NHS Executive is part of the UK Department of Health, with a central office in London and in Leeds and eight regional offices spread across the country. The Executive provides managerial support to the NHS. NHS trust NHS trusts are public bodies within the UK National Health Service, responsible for providing hospital and community health care. NNT The NNT or number needed to treat is the term used to define the reciprocal of the risk or rate difference. In a comparative study of two treatments A and B, suppose that the number of patients cured after receiving treatments A and B are 80/100 and 60/100 respectively. Then the difference in rate of cure is equal to 20/100. The reciprocal of this value, 5, is the NNT. This is interpreted as 'on average 5 patients need to be treated with
110 Dictionary of Evidence-based Medicine treatment A for one more patient to be cured than would be the case if they received treatment B'. The NNT applies to risk of harm too. Suppose that following treatment with A and B, the rates of headache in the two groups of 100 patients in the same trial were 20/100 and 15/100. The estimate difference in risk would be 5/100 to give a reciprocal or NNT of 20. In other words, treating patients with A instead of B would on average result in one more case of headache per 20 patients (see under Risk reduction and Risk). Normal distribution A random variable is one, say X, which follows the probability density distribution fix) : f(x) = where jj, is the mean and c» 2 is the variance of the distribution. The normal distribution is used to model many continuous variables such as weight, blood pressure and height. If we have a normally distributed variable X with mean jo, and variance cr 2 which can be written more simply as N(ji,a 2 ) then any linear transformation of X such as flX + b will also be normally distributed as follows N(a[i + b,a 2
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Dictionary of Evidence-based Medici
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Preface This book was conceived at
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A Ability to pay Ability to pay is
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Figure I Audit: Clinical audit cycl
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B Balanced design In an experiment,
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Page 66 and 67: Figure 9 Concept of externality Dic
Page 72 and 73: G Game theory Game theory, first de
Page 86 and 87: I ICD (see International Classifica
Page 94 and 95: K Keynes, John Maynard (1883-1946)
Page 100 and 101: M Macroeconomics Macroeconomics is
Page 112 and 113: N N of I trial An N of 1 trial is a
Page 116 and 117: o OBM (see Opinion-based medicine)
Page 140 and 141: Figure 25 Measuring quality of life
Page 150 and 151: S Scarcity Scarcity is often referr
Page 158 and 159: T TDM (see Therapeutic drug monitor
Page 162 and 163: u Unique value effect This term is
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Z Z variate A random variable which
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