Dictionary of Evidence-based Medicine.pdf

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Dictionary of Evidence-based Medicine 113 Off-label use Off-label use of medicines refers to their prescribing and use outside the licensed indications. This is a common practice in paediatrics and obstetrics since, for ethical reasons, trials are difficult to conduct in the subject groups concerned. Therefore, when the drug dossiers are submitted for licensing of the products concerned, manufacturers usually put in a disclaimer and in the absence of data, the licensing authorities are unable to make meaningful comments except those based on pre-clinical animal data. Oligopoly (see under Oligopsony) Oligopsony An oligopsony is a market characterized by a few large buyers so that each needs to take careful account of the others' reactions when formulating their own purchasing strategies. In contrast, an oligopoly is a market characterized by a few large manufacturers or suppliers. Again, each needs to carefully consider the others' potential reactions when formulating their own pricing strategies. Just like monopolies, oligopolies exist only if there are sufficient barriers to prevent other firms from entering the market. Both technical and strategic barriers can exist (e.g. barriers to entry presented by branding or patents, both of which are important in the pharmaceuticals industry). ONS (see Office of National Statistics) OPCS (see Office of Population Censuses and Surveys) Open-ended contingent valuation (see under Contingent valuation) Operational research Operational research is the use of qualitative methods for modelling complex systems in an environment of constraint, uncertainty and change so that a better understanding of those systems can be obtained and their solutions sought within the resultant structured framework. The aim of OR practitioners is to improve organizational performance through better decisions (see also Decision analysis).
114 Dictionary of Evidence-based Medicine Opinion-based medicine Opinion-based medicine (OEM) is the use of expert or consensus opinion in the practice of medicine. This approach contrasts with evidence-based medicine which focuses on systematic evaluation of the available evidence. In practice, given that randomized controlled trials have answered only a few of the many clinically relevant questions, even the keenest EBM enthusiast will have to resort to OBM at least some of the time. Opportunity cost Opportunity cost refers to the value of goods and services foregone by not adopting the next best alternative. By adopting one alternative, one is foregoing the benefit to be derived from the next best alternative. Oregon plan This was an attempt by the US Oregon Health Services Commission to revise Oregon's Medicaid program through a cost benefit analysis of the various health services. The objective was to produce a priority list of services from which specific services could be chosen for coverage in order of their appearance in the list until the budget was exhausted. The initial rankings caused much controversy because many were clinically counterintuitive. A notorious example of this was the higher priority assigned to dental caps for pulp exposure than to surgery for ectopic pregnancy. Revised rankings have since been produced (Eddy DM (1991) Oregon's methods. Did cost-effectiveness analysis fail Journal of the American Medical Association. 266: 2135-41). Orthogonality In statistical analysis, orthogonality is said to exist when there is no correlation between the experimental levels of the predictor variables and the effects of the various variables can be estimated independently. Outcome measure (see Outcomes) Outcomes Any measure of health status used in monitoring patients in observation or intervention trials. The narrower term 'endpoints' refers to health events
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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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Figure 9 Concept of externality Dic
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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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