Dictionary of Evidence-based Medicine.pdf

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Dictionary of Evidence-based Medicine 127 Primary care trusts (see under Primary care groups) Primary outcome measure In a clinical trial, a primary outcome measure is a prospectively defined outcome which the investigators consider to be of primary importance. Such an outcome can then be used to define the sample size of the trial and to define clinically meaningful changes on which to base judgements as to whether a treatment is effective or not. Such outcome measures can be supplemented with secondary outcome measures. The latter can be used to support the conclusions to be drawn from the primary outcomes or to generate new hypotheses. 'Primary and secondary outcome measures' are also used in meta-analyses. Primary-secondary care interface The interface between health care workers employed in hospitals on the one hand and general practice on the other. Prisoners' dilemma The prisoners' dilemma is a classic scenario in game theory used to illustrate how independent decision making can lead to inferior results for the parties involved. Similar scenarios are widely used to illustrate decision making by players in an oligopoly (a market dominated by a few firms which have to consider each other's possible retaliatory actions) (Gibbons R (1992) A primer in game theory. Harvester Wheatsheaf, Hertfordshire). Private goods (see under Public goods) Probabilistic functionalism Probabilistic functionalism is an approach suggested by Egon Brunswik for studying and modelling human judgement (Brunswik E (1955) Representative design and probabilistic theory in a functional psychology. Psychological Review. 62: 193-217). The approach is based on two propositions: (i) that the chief task of psychology is to understand how an individual functionally relates to his or her environment; (ii) that the relationships are stochastic or based on probabilistic relationships.
128 Dictionary of Evidence-based Medicine Probability of superiority estimate In a comparative study, the probability of superiority estimate (PS) is the probability that a randomly sampled patient from a population given a test treatment will have a superior outcome to that of a randomly sampled patient from a population given the control treatment. An unbiased estimate of PS is given by U/nji 2 where IT is the Mann- Whitney statistic and n^ and n 2 are the sample sizes for the two groups. The PS is an attractive method for expressing comparative efficacy of two interventions. Note, however, that it requires dichotomizing continuous response data and defining when a treatment is superior to another, which may not always be easy (Grissom RJ (1994) The probability of superiority of one treatment over another. Journal of Applied Psychology. 79: 314-16. Colditz GA, Miller JN, Mosteller F (1988) The effect of study design on gain in the evaluation of new treatments in medicine and surgery. Drug Information Journal 22: 343-52). Standardizing the continuous data to the standard normal deviate Z has been proposed (see Effect size and Appendix in Colditz et al. referred to above). PS has also been called the common language effect size in this context (McGraw KO, Wong SP (1992) A common language effect size statistic. Psychological Bulletin. Ill: 361-5). The PS is then the area to the left of the Z value under the standard normal curve. Thus, if the Z value is 1.645, the PS = 0.95. If Z = -1.645 then the PS = 0.05. If a series of PS values are available from k trials then a pooled PS can be obtained by first obtaining a pooled Z value: A sample weighted pooled Z score (Z ps = ~—-') can be obtained and the corresponding PS read from the appropriate standard normal table.
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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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G Game theory Game theory, first de
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Page 82 and 83: Dictionary of Evidence-based Medici
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
Page 170: Z Z variate A random variable which
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