R&D PROGRAMME/ CENTRE: A coherent set of individual projects for which a single grant-holder/ contractor/ director is accountable, and on which the funder evaluates and keeps data as a programme/ unit.
R&D PROJECT: A discrete time-limited study or piece of non-commercial research, with a specific protocol, grant and identification code attached to it (including fellowships).
RANDOM Governed by a formal chance process in which the occurrence of a previous event is of no value in predicting future events, e.g. 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.
RANDOM SAMPLE A sample derived by selecting sampling units (e.g. 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 (e.g. by a table of randomly ordered numbers).
RANDOMIZED CONTROL TRIAL (RCT) (Syn: controlled clinical trial (CCT)) 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.
RANKING SCALE (Syn: ordinary 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.
RAPID CYCLE TESTING (RCT). A method for achieving improvement in an organisation, It starts with 3 questions 1. What do I want to accomplish or what is the goal 2 How will I measure and know that what I do is an improvement 3. What change can I make in the process or the way I deliver care that will give a better outcome every time? After these questions are answered the PDSA cycle can be started.
RATES (Syn: risk, rate of occurrence) 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 I00 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, e.g. 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. See ADJUSTED RATES, ENCOUNTER RATES, MORBIDITY-MORTALITY RATES.
RATIO (Syn: risk rate, risk 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. See also PROPORTION.
RATIO SCALE A scale in which the distances between all levels along the scale have known numeric values and starts from a zero, e.g. number of children.
RCGP: Royal College of General Practitioners http://www.rcgp.org.uk
REACCREDITATION In North America the established terminology is that doctors are recertificated and training programmes are reaccredited.
READ CLINICAL CLASSIFICATION The nomenclature of different classifications used by the NHS in the UK for the whole health care service.
REASON FOR ENCOUNTER (Syn: RFE) 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 self-confidence through removal of doubt.
RECERTIFICATION In North America the established terminology is that doctors are recertificated and training programmes are reaccredited.
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.
RECORD VALIDITY Medical records whether paper or electronic, record health events. Records are valid when all those events that constitute a medical record are correctly recorded and all the netries in the record truly signify an event
RECORDER The person who records or supervises the recording of information under study.
REDUCTIVE THEORY (Syn: ontological 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 patient's illness in its correct disease category and prescribe a remedy that will remove or neutralise the causal agent." (McWhinney, 1981).
REFERRAL MANAGEMENT CENTRE (RMC) This is a generic term used to describe various process undertaken by PCTs involving the intervention of GP electronic referrals for a given set of objectives. There are various models currently in use by PCTs and LHCs with new developments to support delivery of Booking and Choice.
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.
regard to the chosen parameter. See STATISTICAL SIGNIFICANCE, INFERENCE.
REGIONAL WORKFORCE DEVELOPMENT CONFEDERATION. The 3 NHS funding streams for training (MADEL, SIFT. NMET) are being merged to be administered by this confederation.
REGISTER (Syn: registry) 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 POPULATION The total number of active registered patients in a practice, taken at the mid-point 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. See PRACTICE POPULATION.
REGISTERED PRACTITIONER Listed on a register of those entitled to practice medicine:
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 `xl,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.
REIMBURSEMENT MECHANISMS Mechanisms and legal and regulatory rules for the reimbursement process. Reimbursement is for health care expenses to the patient by insurance organizations.
RELATIVE BENEFIT INCREASE RBI: the increase in the rates of good events, comparing experimental and control patients in a trial, also calculated as |EER-CER|/CER.
RELATIVE RISK 1. The ratio of the risk of a health problem or death among the exposed to the risk among the unexposed (Syn: risk ratio). 2. The ratio of the cumulative incidence rate in the exposed to the cumulative incidence ratio in the unexposed.
RELATIVE RISK INCREASE RRI : the increase in rates of bad events, comparing experimental patients to control patients in a trial, and calculated as for RBI. RRI is also used in assessing the effect of risk factors for disease.
RELATIVE RISK REDUCTION RRR: The proportional reduction in outcome rates between control and experimental patients in a trial, the proportional reduction in rates of bad events between experimental (experimental event rate [EER]) and control (control event rate [CER]) patients in a trial, calculated as |EER-CER|/CER and accompanied by a 95% confidence interval (CI).
RELIABILITY The extent to which the same measure will provide the same results under the same conditions, i.e. 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 intraobserver, test-retest or temporal, and inter-item or internal consistency.
RELIABILITY, TEST OF The consistency with which an instrument measures a given variable.
REPOSITORIES archive knowledge in formal and informal ways so that organisational knowledge is captured from different perspectives
REPRESENTATIVE SAMPLE means that a sample represents the population in some defined ways, i.e. most often age and gender, but it can also include social class and other socio-economic background variables.
REPRESENTIVENESS HEURISTIC: A tendency to treat events as representative of some well known class or pattern
RESEARCH & DEVELOPMENT RESOURCE BASE (RDRB) database of The Research & Development resource base. This is a bibliographic database of almost 8,000 references that collects in one place many of the references to the literature of continuing health professional education. email a.taylor.vaisey@utoronto.ca
RESEARCH ACTIVE PROFESSIONAL (RAP): A person wholly or partly employed by an organisation providing NHS care (including honorary contracts) who undertakes R&D including both project related and general R&D activities. It does not include those individuals (such as research nurses) who are wholly funded by the project funder.
RESEARCH ETHICS COMMITTEE: Committee convened to provide independent advice and approval for projects, care organisations and professionals on the extent to which proposals for the study comply with recognised ethical standards.
Research on tissue / DNA samples: Laboratory-based research that depends on tissue samples obtained from patients (biopsies, blood tests); results may not necessarily be related to individual patient outcomes.
RESEARCH PRACTICE A practice organized and equipped for data collection and research studies.
RESEARCH SPONSOR. This is the organisation taking primary responsibility for ensuring that the study meets appropriate standards and that arrangements are in place to ensure appropriate conduct and reporting; the sponsor is usually but does not have to be the main funder
RESEARCH: finding out what we ought to do (see audit) or the attempt to derive generalisable new knowledge by addressing clearly defined questions with systematic and rigorous methods
RESEARCHERS: Members of the research team other than the Principal Investigator.
RESOURCE A source of support (e.g. family) or expertise which can be drawn upon, a service (e.g. library) or a person to whom one can refer. Also used as financial provision e.g. 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 AUDIT: the review of previous medical care
RETROSPECTIVE STUDY A study of case histories or events after they have occurred.
RETURN TO WORK PROGRAMME in relation to professional performance is the term used to describe the structured process by which a practitioner returns to safe professional practice.
REVALIDATION. A set of procedures being developed which will lead to periodic assessment of every doctor’s fitness to practise. The GMC wants to have a system that will link a doctors regular demonstration that he/she remains fit to practice to GMC registration. This includes a record of CME, a portfolio of wider professional development, a record of participation in and results of clinical and organisation audit, the results of regular appraisals of performance at work showing any changes in performance and set in the context of national professional standards. Doctor’s profiles are likely to take into account the views of patients colleagues and employer.
REVIEW A publication which contains an overview of information on a subject based on the literature and expert knowledge. A general term for all attempts to synthesise the results and conclusions of two or more publications on a given topic. See META-ANALYSIS.
RIGHT TO PERSONAL ACCESS The right recognised in some countries of the individual to access information from his or her medical record.
RISK ANALYSIS A method of assessing risk. 1 his 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.
RISK MANAGEMENT: Actively searching for and correcting potential problems to reduce the future risk of an adverse event.
RISK The probability that a health problem will occur, e.g. that an individual will become ill or die within a stated period of time or age. See also PROBABILITY.
RISK: FACTOR(S) associated with increasing the likelihod of adverse health outcome.
ROADSHOWS – taking a workshop/conference agenda to a variety of set locations over a period of time eg 2 weeks. Sometimes at the request of specific organisations, often to ‘spread the message’
ROLE PLAY. (Simulation) Learners are given social roles to act out in a given situation
RUBRIC (Syn: item) Section or chapter heading. Used in classifications with reference to groups of diseases.
RURAL PRACTICE POPULATION See POPULATION, PRACTICE.