Health Technology Assessment Glossary

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Glossary

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Notes: { }: Parentheses show the unit number where the term is first discussed or defined. For example, {1} indicates that the word is defined in the Lecture Materials for Unit 1.

[ ]: Square brackets show the reference number for the document as listed in the References section of this website. For example [1] indicates Reference # 1.

Term Definition

A

B

Clinical Founded on observation and treatment of actual patients, as distinguished from data or facts obtained by pathology or experimentation [91] {1}
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Clinical Practice Guidelines Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [79] {1}
Also termed practice guidelines .

Clinical Protocols See treatment protocols .

Confounder A characteristic or factor that causes (or prevents) the health outcome of interest, and which is also correlated with the causative factors or characteristics being investigated. Confounders, if not controlled for, cause bias in the estimate of the impact of the causative factors or characteristics being investigated. {3}
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Cost-Benefit Analysis (CBA) An economic evaluation comparing the costs and consequences of two or more alternatives, where all costs and consequences are converted to money values. {4}
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Cost-Consequence Analysis (CCA) An economic evaluation comparing the costs and consequences of two or more alternatives, where costs and consequences are not aggregated, and all health outcomes are left in natural units. {4}
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Cost-Effectiveness Analysis (CEA) An economic evaluation comparing the costs and consequences of two or more alternatives, where at least one health outcome is left in natural units. {4}
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Cost-Minimization Analysis (CMA) An economic evaluation comparing the costs and consequences of two or more alternatives that produce identical health outcomes. {4}
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Cost-Utility Analysis (CUA) An economic evaluation comparing the costs and consequences of two or more alternatives, where the value of consequences is assessed by means of utility ratings. {4}
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Discount Rate Society's rate of time preference, like an interest rate, describing the amount by which we prefer to receive benefits now rather than in the future (or prefer to pay costs in the future, rather than at present). {2}
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Economics 1) Economics is the study of how men and society end up choosing, with or without the use of money, to employ scarce productive resources that could have alternative uses, to produce various commodities and distribute them for consumption, now or in the future, among various people and groups in society. It analyzes the costs and benefits of improving patterns of resource allocation. [86] {4}
2) Economics is the study of the use of scarce resources to satisfy unlimited human wants. [64] {4}

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Economic Analysis See economic evaluation .

Economic Appraisal See economic evaluation .

Economic Assessment See economic evaluation .

Economic Evaluation 1) The comparative analysis of alternative courses of action in terms of both their costs and their consequences. [88] {1}
2) A set of formal quantitative methods used to compare alternative strategies with respect to their resource use and their expected outcomes. {1}

Also termed: economic analysis , economic appraisal , economic assessment

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Effectiveness The ability to cause the expected or intended effect under normal and usual conditions (evidence from clinical trials in ordinary settings, or from multiple centres) {1}
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Efficacy The ability to cause the expected or intended effect under ideal conditions (evidence from in vitro studies, or a clinical trial in an unusual or ideal setting such as an elite teaching hospital) {1}
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Evidence-Based Medicine (EBM) 1) Is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. [85] {1}
2) The process of systematically finding, appraising, and using contemporaneous research findings as the basis for clinical decisions. Evidence-based medicine asks questions, finds and appraises the relevant data, and harnesses that information for everyday clinical practice. Evidence-based medicine follows four steps: formulate a clear clinical question from a patient's problem; search the literature for relevant clinical articles; evaluate (critically appraise) the evidence for its validity and usefulness; implement useful findings in clinical practice. The term "evidence-based medicine" (no hyphen) was coined at McMaster Medical School in Canada in the 1980's to label this clinical learning strategy, which people at the school had been developing for over a decade. [79, cited as "from BMJ 1995;310:1122"].

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Ex Ante Study A technology assessment or other evaluation study undertaken before the collection of actual data; a hypothetical or modelling approach. {2}
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Ex Post Study A technology assessment or other evaluation study based on actual data, for instance case series, clinical trial, or chart review methods. {2}
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Experimental Studies Prospective studies involving the assignment of patients to two or more treatment and control groups. {3}
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F

Grey Literature Studies not indexed in MEDLINE or similar electronic databases; also called "fugitive literature". Methods for finding grey or fugitive literature include checking the references of indexed studies, and the references of referenced studies; searching Current Contents; searching clinical trial registers; contacting researchers to obtain unpublished studies; contacting governments, professional associations, or other relevant bodies for internal studies; searching libraries for doctoral dissertations; and seeking out and translating studies published in non-English language journals. {5}
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Health The absence of disease or infirmity; a condition in which all functions of the body and mind are normally active. {1}
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Health Care Goods and services for the diagnosis and treatment of disease and the maintenance of health; used by consumer/patients solely or primarily because of their anticipated (positive) impact on health status. {1}
Also termed: health services .

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Health Care Technology The drugs, devices, and medical and surgical procedures used in medical care and the organizational and supportive systems within which such care is provided. [81] {1}
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Health Care Technology Assessment (HTA) 1) Technology assessment is a comprehensive form of policy research that examines long- and short-term consequences of the application of technology. [3] {1}
2) Health technology assessment (HTA) is the systematic evaluation of the properties, effects and/or other impacts of health care technology. Its primary purpose is to provide objective information to support health care decisions and policy making at the local, regional, national and international levels. [from http://www.ahfmr.ab.ca/programs.html ] {1}

Also termed: health technology assessment .

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Health-Related Quality of Life (HRQOL) Aspects of quality of life that are related to health or health care. Examples include survival; ability to perform normal physical tasks such as walking, driving a car, going to work, or caring for oneself or others; freedom from depression; freedom from pain; ability to see, hear, speak, and think normally. {4}
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Health Services See health care .

Health Services Research (HSR) The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. [79, cited there as "from Last, Dictionary of Epidemiology, 2d ed."] {1}
Also see health services policy research .

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Health Services Policy Research Synonym for HSR ; the addition of the word "policy" makes explicit that the research is intended to affect policy (whether administrative, financial, or clinical), but in general most HSR is intended to affect policy whether or not this is made explicit. {1}
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Health Status The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [79] {1}
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Health Technology Assessment (HTA) See health care technology assessment .

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J

K

League Table A table showing the cost-effectiveness (usually cost per life-year) or cost-utility (usually cost per QALY ) of different interventions. Interventions are usually ranked from low cost to high cost to facilitate comparison. {4}
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Managed Care Programs Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations. [79] {1}
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Marginal Occurring "at the margin". Refers to the extra, or incremental, costs or effects of each alternative when compared to the other. {4}
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N

Observational Studies Studies involving observation of actual patients, either prospectively or retrospectively, where the study method is not intended to alter or influence patient or practitioner behaviour. {3}
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Outcome Assessment Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure). [79] {1}
Also see outcome and process assessment , process assessment .

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Outcome and Process Assessment Evaluation procedures that focus on both the outcome or status ( Outcome Assessment ) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process ( Process Assessment ) - what is done for the patient diagnostically and therapeutically. [79] {1}
Also see outcome assessment , process assessment .

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Pharmacoeconomics Pharmacoeconomics is the application of the methods of economic evaluation of health care programs to interventions involving pharmaceutical products. [18] {1}
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Practice Guidelines See clinical practice guidelines .

Process Assessment Evaluation procedures that focus on what is done for the patient diagnostically and therapeutically during an episode of care. [79] {1}
Also see outcome and process assessment , outcome assessment .

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Prospective Concerning medical, social, and environmental factors encountered from the time of the beginning of the study until the investigation is terminated. {4}
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Quality-adjusted life year (QALY) QALYs are calculated by multiplying the number of life years added by an intervention by a standardized weight reflecting health-related quality of life during the added years. A weight of 0 typically represents death, and 1 represents perfect health. Weights of less than 1 are possible for health states considered worse than death. Weights are obtained by asking relevant individuals which health states they prefer, and by how much. [18] {4}
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Randomized Controlled Trial, Randomized Control Trial, Randomized Clinical Trial (RCT) Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply Controlled Clinical Trials. [79] {1}
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Retrospective Concerning medical, social, and environmental factors encountered before the beginning of the study. {4}
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Safety The ability to cause no harm when used as intended {1}
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Selection Bias The introduction of error due to systematic differences in the characteristics of those selected to participate in a study, or receive an intervention. Two types of selection bias can be distinguished. In sampling bias, error results from failure to ensure that all members of the reference population have a known chance of being selected for inclusion in the sample. In allocation bias, error results from systematic differences in the characteristics of those assigned to treatment versus control groups in a controlled study. Allowing potential participants to self-select for participation or for intervention introduces selection bias. {3}
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Sensitivity Analysis A method used by economists (and others) to test whether variations in assumptions affect the conclusions of a cost-benefit or similar study. {2}
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Surrogate Outcome Measure A health outcome measure which is not the true goal (of screening, prevention, diagnosis, or therapy), but which is intended to substitute for the final health outcome of interest. Surrogate outcome measures are generally chosen because they can be measured earlier than the primary outcome. { 3}
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Synthesis Study A study which combines all available information in order to arrive at a coherent conclusion or result. Examples include meta-analysis, decision analysis, systematic reviews, and cost-benefit or cost-effectiveness analysis. {2}
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Systematic Review A critical review performed using systematic methods designed to minimize bias, in order to synthesize the existing evidence on a specified topic. {5}
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Total Quality Management The application of industrial management practice to systematically maintain and improve organization-wide performance. Effectiveness and success are determined and assessed by quantitative quality measures. [79] {1}
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Treatment Protocols Precise and detailed plans for the study of a medical or biomedical problem and/or plans for a regimen of therapy. [79] {1}
Also termed clinical protocols .

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Utility Satisfaction, psychological value, or feeling of well-being. {4}
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Utilization Review An organized procedure carried out through committees to review admissions, duration of stay, professional services furnished, and to evaluate the medical necessity of those services and promote their most efficient use. [79] {1}
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Copyright © 1998 Rebecca N. Warburton and School of Health Information Science, University of Victoria
Last modified: January 10, 2002

Notes:	{ }:	Parentheses show the unit number where the term is first discussed or defined. For example, {1} indicates that the word is defined in the Lecture Materials for Unit 1.
	[ ]:	Square brackets show the reference number for the document as listed in the References section of this website. For example [1] indicates Reference # 1.

Term	Definition
A
B
Clinical	Founded on observation and treatment of actual patients, as distinguished from data or facts obtained by pathology or experimentation [91] {1} Use your browser's "BACK" button to return to the page you were viewing previously
Clinical Practice Guidelines	Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [79] {1} Also termed practice guidelines .
Clinical Protocols	See treatment protocols .
Confounder	A characteristic or factor that causes (or prevents) the health outcome of interest, and which is also correlated with the causative factors or characteristics being investigated. Confounders, if not controlled for, cause bias in the estimate of the impact of the causative factors or characteristics being investigated. {3} Use your browser's "BACK" button to return to the page you were viewing previously
Cost-Benefit Analysis (CBA)	An economic evaluation comparing the costs and consequences of two or more alternatives, where all costs and consequences are converted to money values. {4} Use your browser's "BACK" button to return to the page you were viewing previously
Cost-Consequence Analysis (CCA)	An economic evaluation comparing the costs and consequences of two or more alternatives, where costs and consequences are not aggregated, and all health outcomes are left in natural units. {4} Use your browser's "BACK" button to return to the page you were viewing previously
Cost-Effectiveness Analysis (CEA)	An economic evaluation comparing the costs and consequences of two or more alternatives, where at least one health outcome is left in natural units. {4} Use your browser's "BACK" button to return to the page you were viewing previously
Cost-Minimization Analysis (CMA)	An economic evaluation comparing the costs and consequences of two or more alternatives that produce identical health outcomes. {4} Use your browser's "BACK" button to return to the page you were viewing previously
Cost-Utility Analysis (CUA)	An economic evaluation comparing the costs and consequences of two or more alternatives, where the value of consequences is assessed by means of utility ratings. {4} Use your browser's "BACK" button to return to the page you were viewing previously
Discount Rate	Society's rate of time preference, like an interest rate, describing the amount by which we prefer to receive benefits now rather than in the future (or prefer to pay costs in the future, rather than at present). {2} Use your browser's "BACK" button to return to the page you were viewing previously
Economics	1) Economics is the study of how men and society end up choosing, with or without the use of money, to employ scarce productive resources that could have alternative uses, to produce various commodities and distribute them for consumption, now or in the future, among various people and groups in society. It analyzes the costs and benefits of improving patterns of resource allocation. [86] {4} 2) Economics is the study of the use of scarce resources to satisfy unlimited human wants. [64] {4} Use your browser's "BACK" button to return to the page you were viewing previously
Economic Analysis	See economic evaluation .
Economic Appraisal	See economic evaluation .
Economic Assessment	See economic evaluation .
Economic Evaluation	1) The comparative analysis of alternative courses of action in terms of both their costs and their consequences. [88] {1} 2) A set of formal quantitative methods used to compare alternative strategies with respect to their resource use and their expected outcomes. {1} Also termed: economic analysis , economic appraisal , economic assessment Use your browser's "BACK" button to return to the page you were viewing previously
Effectiveness	The ability to cause the expected or intended effect under normal and usual conditions (evidence from clinical trials in ordinary settings, or from multiple centres) {1} Use your browser's "BACK" button to return to the page you were viewing previously
Efficacy	The ability to cause the expected or intended effect under ideal conditions (evidence from in vitro studies, or a clinical trial in an unusual or ideal setting such as an elite teaching hospital) {1} Use your browser's "BACK" button to return to the page you were viewing previously
Evidence-Based Medicine (EBM)	1) Is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. [85] {1} 2) The process of systematically finding, appraising, and using contemporaneous research findings as the basis for clinical decisions. Evidence-based medicine asks questions, finds and appraises the relevant data, and harnesses that information for everyday clinical practice. Evidence-based medicine follows four steps: formulate a clear clinical question from a patient's problem; search the literature for relevant clinical articles; evaluate (critically appraise) the evidence for its validity and usefulness; implement useful findings in clinical practice. The term "evidence-based medicine" (no hyphen) was coined at McMaster Medical School in Canada in the 1980's to label this clinical learning strategy, which people at the school had been developing for over a decade. [79, cited as "from BMJ 1995;310:1122"]. Use your browser's "BACK" button to return to the page you were viewing previously
Ex Ante Study	A technology assessment or other evaluation study undertaken before the collection of actual data; a hypothetical or modelling approach. {2} Use your browser's "BACK" button to return to the page you were viewing previously
Ex Post Study	A technology assessment or other evaluation study based on actual data, for instance case series, clinical trial, or chart review methods. {2} Use your browser's "BACK" button to return to the page you were viewing previously
Experimental Studies	Prospective studies involving the assignment of patients to two or more treatment and control groups. {3} Use your browser's "BACK" button to return to the page you were viewing previously
F
Grey Literature	Studies not indexed in MEDLINE or similar electronic databases; also called "fugitive literature". Methods for finding grey or fugitive literature include checking the references of indexed studies, and the references of referenced studies; searching Current Contents; searching clinical trial registers; contacting researchers to obtain unpublished studies; contacting governments, professional associations, or other relevant bodies for internal studies; searching libraries for doctoral dissertations; and seeking out and translating studies published in non-English language journals. {5} Use your browser's "BACK" button to return to the page you were viewing previously
Health	The absence of disease or infirmity; a condition in which all functions of the body and mind are normally active. {1} Use your browser's "BACK" button to return to the page you were viewing previously
Health Care	Goods and services for the diagnosis and treatment of disease and the maintenance of health; used by consumer/patients solely or primarily because of their anticipated (positive) impact on health status. {1} Also termed: health services . Use your browser's "BACK" button to return to the page you were viewing previously
Health Care Technology	The drugs, devices, and medical and surgical procedures used in medical care and the organizational and supportive systems within which such care is provided. [81] {1} Use your browser's "BACK" button to return to the page you were viewing previously
Health Care Technology Assessment (HTA)	1) Technology assessment is a comprehensive form of policy research that examines long- and short-term consequences of the application of technology. [3] {1} 2) Health technology assessment (HTA) is the systematic evaluation of the properties, effects and/or other impacts of health care technology. Its primary purpose is to provide objective information to support health care decisions and policy making at the local, regional, national and international levels. [from http://www.ahfmr.ab.ca/programs.html ] {1} Also termed: health technology assessment . Use your browser's "BACK" button to return to the page you were viewing previously
Health-Related Quality of Life (HRQOL)	Aspects of quality of life that are related to health or health care. Examples include survival; ability to perform normal physical tasks such as walking, driving a car, going to work, or caring for oneself or others; freedom from depression; freedom from pain; ability to see, hear, speak, and think normally. {4} Use your browser's "BACK" button to return to the page you were viewing previously
Health Services	See health care .
Health Services Research (HSR)	The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. [79, cited there as "from Last, Dictionary of Epidemiology, 2d ed."] {1} Also see health services policy research . Use your browser's "BACK" button to return to the page you were viewing previously
Health Services Policy Research	Synonym for HSR ; the addition of the word "policy" makes explicit that the research is intended to affect policy (whether administrative, financial, or clinical), but in general most HSR is intended to affect policy whether or not this is made explicit. {1} Use your browser's "BACK" button to return to the page you were viewing previously
Health Status	The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [79] {1} Use your browser's "BACK" button to return to the page you were viewing previously
Health Technology Assessment (HTA)	See health care technology assessment .
I
J
K
League Table	A table showing the cost-effectiveness (usually cost per life-year) or cost-utility (usually cost per QALY ) of different interventions. Interventions are usually ranked from low cost to high cost to facilitate comparison. {4} Use your browser's "BACK" button to return to the page you were viewing previously
Managed Care Programs	Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations. [79] {1} Use your browser's "BACK" button to return to the page you were viewing previously
Marginal	Occurring "at the margin". Refers to the extra, or incremental, costs or effects of each alternative when compared to the other. {4} Use your browser's "BACK" button to return to the page you were viewing previously
N
Observational Studies	Studies involving observation of actual patients, either prospectively or retrospectively, where the study method is not intended to alter or influence patient or practitioner behaviour. {3} Use your browser's "BACK" button to return to the page you were viewing previously
Outcome Assessment	Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure). [79] {1} Also see outcome and process assessment , process assessment . Use your browser's "BACK" button to return to the page you were viewing previously
Outcome and Process Assessment	Evaluation procedures that focus on both the outcome or status ( Outcome Assessment ) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process ( Process Assessment ) - what is done for the patient diagnostically and therapeutically. [79] {1} Also see outcome assessment , process assessment . Use your browser's "BACK" button to return to the page you were viewing previously
Pharmacoeconomics	Pharmacoeconomics is the application of the methods of economic evaluation of health care programs to interventions involving pharmaceutical products. [18] {1} Use your browser's "BACK" button to return to the page you were viewing previously
Practice Guidelines	See clinical practice guidelines .
Process Assessment	Evaluation procedures that focus on what is done for the patient diagnostically and therapeutically during an episode of care. [79] {1} Also see outcome and process assessment , outcome assessment . Use your browser's "BACK" button to return to the page you were viewing previously
Prospective	Concerning medical, social, and environmental factors encountered from the time of the beginning of the study until the investigation is terminated. {4} Use your browser's "BACK" button to return to the page you were viewing previously
Quality-adjusted life year (QALY)	QALYs are calculated by multiplying the number of life years added by an intervention by a standardized weight reflecting health-related quality of life during the added years. A weight of 0 typically represents death, and 1 represents perfect health. Weights of less than 1 are possible for health states considered worse than death. Weights are obtained by asking relevant individuals which health states they prefer, and by how much. [18] {4} Use your browser's "BACK" button to return to the page you were viewing previously
Randomized Controlled Trial, Randomized Control Trial, Randomized Clinical Trial (RCT)	Clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Treatment allocations using coin flips, odd-even numbers, patient social security numbers, days of the week, medical record numbers, or other such pseudo- or quasi-random processes, are not truly randomized and trials employing any of these techniques for patient assignment are designated simply Controlled Clinical Trials. [79] {1} Use your browser's "BACK" button to return to the page you were viewing previously
Retrospective	Concerning medical, social, and environmental factors encountered before the beginning of the study. {4} Use your browser's "BACK" button to return to the page you were viewing previously
Safety	The ability to cause no harm when used as intended {1} Use your browser's "BACK" button to return to the page you were viewing previously
Selection Bias	The introduction of error due to systematic differences in the characteristics of those selected to participate in a study, or receive an intervention. Two types of selection bias can be distinguished. In sampling bias, error results from failure to ensure that all members of the reference population have a known chance of being selected for inclusion in the sample. In allocation bias, error results from systematic differences in the characteristics of those assigned to treatment versus control groups in a controlled study. Allowing potential participants to self-select for participation or for intervention introduces selection bias. {3} Use your browser's "BACK" button to return to the page you were viewing previously
Sensitivity Analysis	A method used by economists (and others) to test whether variations in assumptions affect the conclusions of a cost-benefit or similar study. {2} Use your browser's "BACK" button to return to the page you were viewing previously
Surrogate Outcome Measure	A health outcome measure which is not the true goal (of screening, prevention, diagnosis, or therapy), but which is intended to substitute for the final health outcome of interest. Surrogate outcome measures are generally chosen because they can be measured earlier than the primary outcome. { 3} Use your browser's "BACK" button to return to the page you were viewing previously
Synthesis Study	A study which combines all available information in order to arrive at a coherent conclusion or result. Examples include meta-analysis, decision analysis, systematic reviews, and cost-benefit or cost-effectiveness analysis. {2} Use your browser's "BACK" button to return to the page you were viewing previously
Systematic Review	A critical review performed using systematic methods designed to minimize bias, in order to synthesize the existing evidence on a specified topic. {5} Use your browser's "BACK" button to return to the page you were viewing previously
Total Quality Management	The application of industrial management practice to systematically maintain and improve organization-wide performance. Effectiveness and success are determined and assessed by quantitative quality measures. [79] {1} Use your browser's "BACK" button to return to the page you were viewing previously
Treatment Protocols	Precise and detailed plans for the study of a medical or biomedical problem and/or plans for a regimen of therapy. [79] {1} Also termed clinical protocols . Use your browser's "BACK" button to return to the page you were viewing previously
Utility	Satisfaction, psychological value, or feeling of well-being. {4} Use your browser's "BACK" button to return to the page you were viewing previously
Utilization Review	An organized procedure carried out through committees to review admissions, duration of stay, professional services furnished, and to evaluate the medical necessity of those services and promote their most efficient use. [79] {1} Use your browser's "BACK" button to return to the page you were viewing previously
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