IATROGENIC DISEASE A health problem caused by a physician's diagnostic or therapeutic activities.
ICD See INTERNATIONAL CLASSIFICATION OF DISEASE.
ICEBERG PHENOMENON Refers to the situation where only a part of the health problems is detected, specifically because of people not seen by health care providers, and because patients deliberately do not present all their health concerns when attending. The `visible' part is the detected health problems, and the `submerged' part is health problems not yet diagnosed or medically attended to.
ICPC See INTERNATIONAL CLASSIFICATION OF PRIMARY CARE.
IDENTIFICATION NUMBER Different countries have developed different codes by which they can identify each individual. They often consist of digits from date of birth, gender, etc.
ILLNESS BEHAVIOUR The conduct of a person in response to abnormal mental and physical signals. Such behaviour influences the manner in which a person monitors, defines, and interprets bodily symptoms, takes remedial actions, and uses the health care system. See also HEALTH BEHAVIOUR.
ILLNESS DIVERSITY The number of different episodes experienced by a patient in a year.
ILLNESS The subjective state of the person, who is aware of having a. health problem and not feeling well. See also DISEASE, HEALTH PROBLEM, SICKNESS.
ILO Intended learning outcomes
IMD Index of Multiple Deprivation (see definition)
IMPAIRMENT Any reduction or abnormality of psychological, physiological, or anatomical structure or function.
IMRAD Abbreviation of the sections of a scientific publication: Introduction, Methods, Results, Analysis and Discussion.
INCEPTION COHORT A designated group of persons, assembled at a common time early in the development of a specific health problem (e.g. at the time of first exposure to the putative cause or at the time of initial diagnosis), who are followed thereafter. See also COHORT.
INCIDENCE: The number of new events (such as new cases of a disease) in a defined population within a specified period of time.
INDEPENDENT PRACTITIONER: A person who has the capacity to exercise their discretion on behalf of others in situations of considerable uncertainty (Colin Coles)
INDEPENDENT VARIABLE See VARIABLE.
IN-DEPTH INTERVIEW An interview method used in qualitative research which aims at understanding the experience from the informant, interpreted by the interviewer. Repeated encounters often help the interviewer (i.e. the researcher) to understand the informant's perspective on his/her situation and life, as expressed by him-/herself.
INDEX An aggregation of two or more distinct health measures into an overall summary measure. In functional status assessment, index means a rating scale derived from a number of measurements on different functional assessment scales which have no internal relationship. See also FUNCTIONAL STATUS INDEX, HEALTH OUTCOME MEASURES, HEALTH STATUS INDEX.
INDEX CONDITIONS Selected health problems or diagnosis chosen for measurement in an audit or research programme as indicators of the overall quality of care.
INDEX OF MULTIPLE DEPRIVATION (IMD): A measure of deprivation based on a number of factors including income, employment, health, education, housing and crime.
INDICATORS Particular elements of care selected for assessment in performance review, and between which a hierarchy and internal relationship exist.
INDUCTION: a form of reasoning that draws a general conclusion from a particular truth already known
INDUSTRIAL PRACTICE A practice conducted within the confines of an industrial organization. Usually the physician is reimbursed by salary, or according to terms of a specific contract. Ancillary staff are usually employees of the industry.
INEQUALITIES IN HEALTH: See Health inequalities
INFANT A child less than one year of age. 1. Neonate: birth to 28 days. 2. Post-neonate: 29 days to 1 year.
INFANT MORTALITY RATE: A measure of the yearly rate of deaths in children less than one-year old, expressed per 1000 live births in the same year.
INFECTION The entry and multiplication of an infectious agent in a person, this may or may not give rise to symptoms or disease. A person carrying an infectious agent without being ill is called a `carrier' of that agent or health problem.
INFERENCE (Syn: clinical inference, scientific inference) Conclusions drawn on evidence from clinical research by the professional community, readers of literature, or even by the investigator who presents the empirical evidence. INFERENCE implies judgement on basis of evidence and prior belief. INFERENCE prior belief in posterior belief, given the scientific evidence. See CAUSALITY. Statistical inference is the development of generalisation from sampled data to a virtually larger popula tion than sampled, usually with calculated degrees of uncertainty around the calculated outcome measure.
INFESTATION (Syn: attack, infiltration, contamination) Usually applied to parasites as causative agents, e.g. infested with lice.
INFORMED CONSENT Consent given by a person who is invited to participate in a research project or a teaching session after being well informed of the aims, consequences, burden, time, risk, etc. He/she must be offered the option of not participating, if so desired, without detriment to the care being received.
INPATIENT (Syn: admitted patient) A patient who is admitted to and spends at least one night in hospital.
INSIDE PRACTITIONER RESEARCH: engages professionals in research on their own practice
INSIGHT in relation to professional performance refers to the practitioner’s understanding and acceptance of the problems identified in relation to their performance, coupled with a willingness to work through a return to work programme. Insight is not an all or nothing concept, but is often referred to in degrees (for example ‘partial insight’) and it may be necessary for work to be done (by a psychologist, coach or mentor) with a practitioner to increase their insight before and during their return to work programme.
INSTITUTIONAL VISIT A professional attendance to two or more patients in one institution on the same occasion.
INSTRUCTIVIST THEORIES: depict learning in terms of the accumulation of acts, and assumes that learning can be assessed by the reproduction of these facts
INTELLECTUAL PROPERTY is the tangible product of an intellectual endeavour
INTERACTIVE Acting upon each other, in the context of education interactive teaching is learning situations in which participants teach and learn at the same time.
INTER-DOCTOR VARIATION Variation between providers in frequencies of health problems, that cannot be explained by the age-sex distribution of their practices. INTER-DOCTOR VARIATION can be observed on reasons for encounters, diagnoses and interventions. INTER-DOCTOR VARIATION is related to small area variation, which concerns more aggregated data on group-practices, hospitals or regions.
INTERFACE (OR INTERPROFESSIONAL) AUDIT: collaborative examination of the way hospital departments, general practice and community services work together
INTERNAL AUDIT: audit of practices activities by the practice staff, using criteria defined by the practice itself
INTERNATIONAL CLASSIFICATION OF DISEASE (ICD) An international classification developed under the auspices of WHO and published periodically as a complete book on diagnostic entities. It is organised in 17 chapters containing more than 12 000 different categories. Each entry is given a numerical code of up to four digits. This publication is called: `Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death'. The Tenth Revision (ICD-10) was introduced on January 1, 1993, but is so far only implemented in very few countries. It replaces ICD-9 published in 1976.
INTERNATIONAL CLASSIFICATION OF HEALTH PROBLEMS IN PRIMARY CARE (Syn: ICHPPC) The classification of diseases and conditions in primary care. First produced by the WONCA CLASSIFICATION COMMITTEE, and it has been revised once under the name ICHPPC-2. It is now replaced by the much more practice orientated ICPC. ICHPPC is structured in the same way as the ICD-9 classification.
INTERNATIONAL CLASSIFICATION OF IMPAIRMENTS, DISABILITIES, AND HANDICAPS (Syn: ICIHD) Published by WHO in 1980 as a taxonomy of the consequences of injury and disease. It uses the following definitions: 1. Impairment: "Any loss or abnormality of psychological, physiological or anatomical structure or function." Impairments represent disturbances at the organ level. 2. Disability: "Any restriction or lack (resulting from an impairment) of ability to perform an activity in a manner or within the range considered normal for a human being." Disability represents disturbances at the level of the person. 3. Handicap: "A disadvantage for a given individual, resulting from an impairment or a disability, that limits or prevents the fulfilment of a role that is normal (depending on age, sex, and social and cultural factors) for that individual." It reflects the adaptation of the individual to his/her surroundings.
INTERNATIONAL CLASSIFICATION OF PRIMARY CARE (Syn: ICPC) The classification which takes best into account the way the GP/FP works. In this classification the reason for the encounter (REF) can be classified as well as the diagnostic processes, intervention, prevention, administrative procedures and the diagnosis. It has a biaxial structure and is built up in 17 chapters, each divided up in 7 components. It has been extensively tested and found to be very practicable and reliable for use in general practice, with less than 3% recording error. It was published by the WONCA Classification Committee in 1980.
INTERPOLATE To predict a value 'within the range of observed values.
INTERVAL SCALE (Syn: dimensional scale) A scale in which the distances between all levels along the scale have known numeric values and with no zero level. See RATIO SCALE.
INVESTIGATION in relation to professional performance refers to a process undertaken locally by a Trust/PCO to understand an adverse event or series of events,
INVESTORS IN PEOPLE. This is a national Standard that sets a level of godd practice for improving an organisations’s performance through its people www.iipuk.co.uk
ITEM A single question or statement and its standardized response scale.
ITP – integrated training post. This is a post usually based in primary care with in-reach to appropriate parts of a hospital job.