Dictionary of Evidence-based Medicine.pdf
Dictionary of Evidence-based Medicine.pdf
Dictionary of Evidence-based Medicine.pdf
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<strong>Dictionary</strong> <strong>of</strong> <strong>Evidence</strong>-<strong>based</strong> <strong>Medicine</strong> 47<br />
<strong>of</strong> the second questionnaire and simultaneous feedback <strong>of</strong> the information<br />
to the respondents; (iv) analysis <strong>of</strong> the results <strong>of</strong> the second questionnaire<br />
and, if necessary, further iteration with more questionnaires until consensus<br />
is achieved. Feedback <strong>of</strong> the information to the respondents at each<br />
stage; (v) presentation <strong>of</strong> the consensus results; (vi) make forecast.<br />
Deterministic models (see Stochastic model)<br />
Discounting<br />
In economic analyses, the fact that costs that are incurred sooner are more<br />
keenly felt than those that are incurred later (a phenomenon referred to as<br />
'positive rate <strong>of</strong> time preference') is taken into account by discounting costs<br />
as they accrue over time. Costs <strong>of</strong> alternative therapies, with different time<br />
pr<strong>of</strong>iles, can therefore be expressed uniformly in terms <strong>of</strong> present values.<br />
The formula used for discounting is as follows:<br />
where P = present value, r = discount rate and a value between 3% and 5%<br />
is <strong>of</strong>ten recommended, C 3 ,C 2 ,C 3 ,...,C n are the costs in year 1, 2, 3,...,n.<br />
Disease management<br />
Disease management is a systematic population-<strong>based</strong> approach to identifying<br />
those at risk, intervening using the best systematically reviewed<br />
evidence and measuring patient outcomes once an intervention is in<br />
effect. Important operational aspects include (i) the development <strong>of</strong> clear<br />
clinical guidelines; (ii) agreement on the part <strong>of</strong> providers and patients to<br />
participate; (iii) establishment <strong>of</strong> an efficient and effective information<br />
infrastructure; (iv) well-designed and tested interventions; (v) a logical<br />
plan for the collection <strong>of</strong> outcomes (Epstein RS, McGlynn MG (1997)<br />
Disease management. What is it Disease Management and Health Outcomes.<br />
1: 3-10).<br />
Domain<br />
In quality <strong>of</strong> life assessments, a domain is a range <strong>of</strong> observables used to<br />
measure a particular construct. For example, one can refer to a physical<br />
function domain which includes a range <strong>of</strong> items aimed at defining that