Dictionary of Evidence-based Medicine.pdf

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A Ability to pay Ability to pay is a criterion often used for determining the level of charges to try to make them fair. Most countries adopt this criterion for taxes by making them progressive in that those on higher income pay a higher proportion of their wages in taxes. In the UK, prescription charges are based on this criterion but with a cut-off point rather than use of a progressive scale (see Benefits received for comparison). Absolute income hypothesis The absolute income hypothesis states that the higher an individual's income, the lower his or her risk of mortality (Pritchett L, Summers LA (1996) Wealthier is healthier. Journal of Human Resources. 31: 841-68). Absolute risk (see under Risk) Academic detailing Academic detailing refers to university-based educational programmes designed to improve physicians' clinical decision making with a view to enhancing the quality and cost-effectiveness of health care. Such programmes, also known as educational outreach or public interest detailing, make use of behavioural science-based approaches adopted by pharmaceutical manufacturers to influence prescribing practices. Techniques used include (i) interviews to define baseline knowledge and motivations for current prescribing patterns; (ii) identification of target categories of physicians and their opinion leaders; (iii) defining clear educational and behavioural objectives; (iv) establishment of credibility through associations with well-respected organizations, citation of authoritative and unbiased sources of information and dispassionate presentation of opposing views while at the same time highlighting preferred options with justifications; (v) encouragement of active physician participation; (vi) use of concise and well-designed graphic educational material; (vii) highlighting and
2 Dictionary of Evidence-based Medicine repeating of essential messages; (viii) provision of positive reinforcements in follow-up visits (Samurai SB A, Avon J (1990) Principles of educational outreach (academic detailing) to improve clinical decision making. Journal of the American Medical Association. 263: 549-56). ACBS (see Advisory Committee on Borderline Substances) Activities of daily living This term refers to measures of independence in the performance of five major personal care activities, specifically: bathing, dressing, eating, getting in and out of bed and using the toilet. Assessment of impairment of physical function is often undertaken using scales constructed from the five activities of daily living (Patrick DL, Erickson P (1993) Health status and health policy. Oxford University Press, Oxford). Acquiescence response set This term refers to the tendency of respondents to agree with statements of opinion regardless of content. For example, it is well known that in research aiming to gauge patient perception (e.g. patient satisfaction questionnaires), respondents to questionnaires sometimes respond positively to pairs of contradictory statements. Indeed, a small proportion of respondents are known to agree with all or nearly all items on questionnaires used in such studies. Such poor internal consistency therefore needs to be accounted for if the results of the studies are to be meaningful. Exclusion of acquiescent patients prior to analysis is not justifiable as a new source of bias may be introduced in the selection of such individuals. Moreover, restricting analysis to the subset of respondents from which acquiescent responders have been eliminated would reduce the external validity or generalizability of the results as acquiescent individuals are often from socioeconomic disadvantaged groups. The use of balance scales (i.e. scales which include items which express both favourable and unfavourable items) is recommended to minimize bias introduced by acquiescent response set. Adaptive design An adaptive design is a type of clinical trial design in which the probability that a patient receives a given treatment is, at least partly, determined by the results obtained with patients so far. An example of such a design is the
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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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I ICD (see International Classifica
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K Keynes, John Maynard (1883-1946)
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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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