WONCA International Classification Committee

QUALY

Acronym for quality-adjusted life years. An adjustment of life expectancy that allows for prevalence of activity-limitations in a group for which QUALY is calculated.

QUALITATIVE DATA

In medical literature the word can have two meanings :
1. Information characterizing a patient, or whatever unit under study, on a nominal scale, ie gender, hair colour, death or nationality. Characteristics on an ordinal scale could be called QUALITATIVE DATA, opposed to quantitative data on interval or ratio scales.
2. Within research, qualitative data are specific information about a person's social life or individual perception. The data are derived through indepth interview, designed as a dialogue between researcher and informant.

QUALITY

The degree of excellence, the relative value.

QUALITY ASSESSMENT

The measurement and judgement of the technical and interpersonal aspects of care.

QUALITY ASSURANCE

Activities performed to determine the extent to which a phenomenon fulfils certain values and activities performed to assure changes in practice that will fulfil the highest or a predetermined level of values. In general/family practice defined as a process of planned activities based on performance review and enhancement with the aim of continually improving standards of patient care.

QUALITY CONTROL

The supervision and control of all operations involved in a process, usually involving sampling and inspection, in order to detect and correct systematic or excessively random variations in quality. Lately introduced in the Health Care Sector in order to make better use of resources and improve the overall quality of care.

QUALITY DEVELOPMENT

A continuous process of planned activities based on performance review and setting of explicit targets for good clinical practice with the aim of improving the actual quality of patient care.

QUALITY OF CARE

A level of performance or accomplishment that characterizes the health care provided. Donabedian has, in relation to health care, classified this into measures of structure, process and outcome.

QUALITY OF LIFE

That which makes life worth living.

QUANTITATIVE DATA

Data in numerical quantities, such as continuous measurements or counts.

QUASI-EXPERIMENT

An observed manoeuvre, change, intervention or event that is not controlled by the investigator who by chance or deliberately gathered data before and after the event. The outcome of that QUASI-EXPERIMENT can be presented as evidence for an association. For instance : observing the health outcome of an earthquake, strike, uncontrolled introduction of a new therapy or health information through the media.

QUESTIONNAIRE

A predetermined set of questions used to collect data, clinical, socioeconomical, functional etc.

RANDOM

Governed by a formal chance process in which the occurrence of a previous event is of no value in predicting future events eg the probability of assignment of a given subject to a specified treatment group is fixed and constant (typically 0. 50) but the subject's actual assignment cannot be known until it occurs.

RANDOMIZED CONTROLLED TRIAL (RCT)

) An epidemiologic experiment in which subjects in a population are randomly allocated into groups, usually called "study" and "control" groups, to receive or not receive an experimental preventive or therapeutic procedure, manoeuvre or intervention. Randomized controlled trials are generally regarded as the most scientifically rigorous method available in medical research.

RANDOM SAMPLE

A sample derived by selecting sampling units (eg individual patients) so that each unit has an independent and fixed (generally equal) chance of selection. Whether a given unit is selected is determined by chance (eg by a table of randomly ordered numbers).

RANKING SCALE

A scale that arrays the members of a group from high to low according to the magnitude of the observations, assigns the numbers to the ranks, and neglects distances between members of the array.

RATES

The number of events or conditions occurring in a study population in a given period of time (nominator), divided by the number in the study population (denominator). A study population may be made up of any of the following groups : registered patients, active patients, inactive patients, etc. Rates per hundred or thousand are typical, but this may change to per 10,000 or per 100,000 as the frequency of the event decreases. For some rates the study population of patients may not constitute the denominator, which instead may refer to the provider, eg the number of patients seen per week per provider. Thus, we may construct rates with one of the following numerators : problems, encounters or services, patients, families, etc. , and one of the following denominators : provider, team, practice, study population, registered patient population, census population, random sample population, etc.

RATIO

The value obtained by dividing one quantity by another. The numerator and the denominator are usually separate and distinct quantities, neither being included in the other. To be distinguished from "proportion" where the numerator is included in part of the denominator.

RATIO SCALE

A scale in which the distances between all levels along the scale have known numeric values and starts from a zero, ie number of children.

READ CLINICAL CLASSIFICATION

The nomenclature of different classifications used by the NHS in the UK for the whole health care service.

REASON FOR ENCOUNTER

The agreed statement of the reason(s) why a person enters the health care system, representing the demand for care by that person. The terms written down and later classified by the provider, clarify the reason for encounter and consequently the patient's demand for care, without interpreting it in the form of a diagnosis. The reason for encounter should be recognized by the patient as an acceptable description of that person's demand for care.

REASSURANCE

Restoration of selfconfidence through removal of doubt.

RECORDER

The person who records or supervises the recording of information under study.

RECORD (MEDICAL)

A file of information relating to transactions in personal health care, comprising data on health status together with personal identifying data, and often incorporating administrative and economic data.

REDUCTIVE THEORY

According to which diseases are entities, caused by external agents, with an existence almost separate from the people who suffer from them. The physician's task is to place the patients illness in its correct disease category and prescribe a remedy that will remove or neutralise the causal agent. (I. McWhinney).

REFERRAL

The process by which the responsibility for part or all of the care of a patient is temporarily transferred to another health care provider. Patients may be referred for a specific service, a general opinion, or for other reasons.

REFERRAL THRESHOLD

The personal level at which a stimulus of a consultation produces a referral.

REIMBURSEMENT MECHANISMS

Mechanisms and legal and regulatory rules for the reimbursement process. Reimbursement is for health care expenses to the patient by insurance organisations.

REGISTER

A file of data concerning patients with a particular health problem in a defined population. The register is the actual list of patients and the registry is the system of registration.

REGISTERED PATIENT

A person listed with a particular doctor or practice.

REGISTERED PRACTITIONER

Listed on a register of those entitled to practice medicine.

REGISTERED POPULATION

The total number of active registered patients in a practice, taken at the midpoint of a study. If the patients are not registered on a list, the exact number of this population is not known. It may be possible to calculate the population from encounter data; if this is done, the method used should be specified.

REGRESSION ANALYSIS

A regression analysis involves finding the best mathematical model to describe a dependent variable "y" as a function of one or more independent variables "x1, x2. . xn".

REHABILITATION SERVICE

A service which promotes restoration of activities and social functioning following a health problem, as nearly as possible to the premorbid level.

RELATIVE RISK

1. The ratio of the risk of a health problem or death among the exposed to the risk among the unexposed
2. The ratio of the cumulative incidence rate in the exposed to the cumulative incidence ratio in the unexposed.

RELIABILITY

The extent to which the same measure will provide the same results under the same conditions, ie is free of measurement error. Stated as the ratio of true score variance to observed score variance. The study of reliability may consist of the following forms of variability : inter and intra-observer, test-retest or temporal, and interitem or internal consistency.

RELIABILITY, TEST OF

The consistency with which an instrument measures a given variable.

REPRESENTATIVE SAMPLE

means that a sample represents the population in some defined ways, ie most often age and gender, but it can also include social class and other socioeconomic background variables.

RESEARCH PRACTICE

A practice organized and equipped for data collection and research studies.

RESOURCE

A source of support (eg family) or expertise which can be drawn upon, a service (eg library) or a person to whom one can refer.
Also used as financial provision eg financial resources for a programme or service.

RESPONDENT

A person answering questions or completing a survey.

RESPONSE RATE

The number of completed interviews or returned questionnaires divided by the total number of persons who were asked to participate in the survey, and expressed as a percentage.

RETROSPECTIVE STUDY

A study of case histories or events after they have occurred.

REVIEW

A publication which contains an overview of information on a subject based on the literature and expert knowledge.

RIGHT TO PERSONAL ACCESS

The right recognised in some countries of the individual to access information from his or her medical record.

RISK

The probability that a health problem will occur, eg, that an individual will become ill or die within a stated period of time or age.

RISK ANALYSIS

A method of assessing risk. This may be used to subsequently compare the cost of achieving something against the risk of losing something.

RISK FACTOR

An aspect of personal behaviour or lifestyle, exposure or individual characteristic, may be inherited, which is known to be associated with ill health and which is considered important in prevention of health problems and which can be modified by a health programme.

RURAL PRACTICE POPULATION

RUBRIC

Section or chapter heading. Used in classifications with reference to groups of diseases.