Dictionary of Evidence-based Medicine.pdf

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Dictionary of Evidence-based Medicine 51 Figure 7 Edgeworth box illustrating the concept of Pareto efficiency curves showing combinations of goods 1 and 2 which they would be equally happy with (curves C). The point at which two indifference curves for the two subjects are at a tangent to each other (point T) is Pareto efficient since at that point it is impossible to improve the position of one subject without harming that of the other. Within the Edgeworth box, there will be many points which are Pareto efficient. These alternatives fall along what is referred to as the contract curve for the two subjects (Folland S, Goodman AC, Stano M (1997) The economics of health and health care. 2nd edn. Prentice Hall, New Jersey). Educational outreach (see Academic detailing) Effect size In meta-analysis, effect size refers to the standardized effect observed. By standardizing the effect, the result becomes dimensionless so that the pooling of effects obtained with different measurement scales can be
52 Dictionary of Evidence-based Medicine undertaken. While this overcomes one problem, it creates another because the results are difficult to interpret. Standardizing the effect is undertaken by dividing the estimate of effect by the control group standard deviation (s c ) or the pooled standard deviation (s p ). The former is sometimes called Glass's effect size and the latter Hedge's effect size, after the authors who proposed them. In reporting effect sizes, it is important to make explicit whether the pooled or control standard deviation is used (Hedges LV, Olkin I (1985) Statistical methods for meta-analysis. Academic Press, San Diego). Effectiveness The effectiveness of a drug refers to the extent to which it achieves its intended purpose for the broad range of patients who will receive it in practice (see Efficacy). Efficacy The efficacy of a drug refers to the extent to which it achieves its intended purpose under the strict conditions of randomized controlled trials, in patients typically recruited in such trials (see Effectiveness). Efficacy analysis (see under Intention to treat analysis) Efficiency In the pharmacoeconomic literature, two types of efficiency are often referred to: technical efficiency and allocative efficiency. With technical efficiency, one is concerned with the technical performance of interventions for dealing with the same problem (e.g. management of prostate cancer) while with allocative efficiency, the focus is on how best to allocate scarce resources across different competing objectives (e.g. provision of day care services versus the setting up of a breast screening clinic). The latter is regarded as being a higher form of efficiency than the former and requires value judgements to be made about the relative value of pursuing different objectives and hence different outputs. More generally, in economics, efficiency refers to optimum use of resources. Technical efficiency is achieved when the maximum amount of output is generated from a given amount of resources. An old hospital was not technically efficient if a new one brings about a reduction in costs for the same throughput of patients. On the other hand, optimum allocative
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Dictionary of Evidence-based Medici
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Preface This book was conceived at
Page 6 and 7: A Ability to pay Ability to pay is
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Page 12 and 13: Figure I Audit: Clinical audit cycl
Page 14 and 15: B Balanced design In an experiment,
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
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N N of I trial An N of 1 trial is a
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o OBM (see Opinion-based medicine)
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Figure 25 Measuring quality of life
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S Scarcity Scarcity is often referr
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T TDM (see Therapeutic drug monitor
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u Unique value effect This term is
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Z Z variate A random variable which
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