A5V4d

Feverish illness in children
Clinical governance A framework through which NHS organisations are accountable for both
continually improving the quality of their services and safeguarding high
standards of care by creating an environment in which excellence in clinical
care will flourish.
Clinical impact The effect that a guideline recommendation is likely to have on the treatment,
or treatment outcomes, of the target population.
Clinical importance The importance of a particular guideline recommendation to the clinical
management of the target population.
Clinical question This term is sometimes used in guideline development work to refer to the
questions about treatment and care that are formulated in order to guide the
search for research evidence. When a clinical question is formulated in a
precise way, it is called a focused question.
Clinical trial A research study conducted with patients which tests out a drug or other
intervention to assess its effectiveness and safety. Each trial is designed to
answer scientific questions and to find better ways to treat individuals with a
specific disease. This general term encompasses controlled clinical trials and
randomised controlled trials.
Clinician A qualified healthcare professional providing patient care, e.g. doctor, nurse,
physiotherapist.
Cluster A group of patients, rather than an individual, used as the basic unit for
investigation. See also cluster design, cluster randomisation.
Cluster design Cluster designs are those where research subjects are not sampled or selected
independently, but in a group. For example, a clinical trial where patients in a
general practice are allocated to the same intervention; the general practice
forming a cluster. See also cluster and cluster randomisation.
Cluster randomisation A study in which groups of individuals (e.g. patients in a GP surgery or on a
hospital ward) are randomly allocated to treatment groups. Take, for example,
a smoking cessation study of two different interventions – leaflets and teaching
sessions. Each GP surgery within the study would be randomly allocated to
administer one of the two interventions. See also cluster and cluster design.
Cochrane Collaboration An international organisation in which people find, appraise and review specific
types of studies called randomised controlled trials. The Cochrane Database of
Systematic Reviews contains regularly updated reviews on a variety of health
issues and is available electronically as part of the Cochrane Library.
Cochrane Library The Cochrane Library consists of a regularly updated collection of evidencebased
medicine databases including the Cochrane Database of Systematic
Reviews (reviews of randomised controlled trials prepared by the Cochrane
Collaboration). The Cochrane Library is available on CD-ROM and the internet.
Cohort A group of people sharing some common characteristic (e.g. patients with the
same disease), followed up in a research study for a specified period of time.
Cohort study An observational study that takes a group (cohort) of patients and follows their
progress over time in order to measure outcomes such as disease or mortality
rates and make comparisons according to the treatments or interventions that
patients received. Thus, within the study group, subgroups of patients are
identified (from information collected about patients) and these groups are
compared with respect to outcome, e.g. comparing mortality between one
group that received a specific treatment and one group that did not (or between
two groups that received different levels of treatment). Cohorts can be
assembled in the present and followed into the future (a ‘concurrent’ or
‘prospective’ cohort study) or identified from past records and followed forward
from that time up to the present (a ‘historical’ or ‘retrospective’ cohort study).
Because patients are not randomly allocated to subgroups, these subgroups
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