Report in English with a Dutch summary (KCE reports 45A)

Report in English with a Dutch summary (KCE reports 45A) Report in English with a Dutch summary (KCE reports 45A)

10.08.2013 Views

8 Screening for Colorectal Cancer KCE reports vol.45 GLOSSARY Term Description The observed or calculated probability of an event in the population Absolute risk under study. Absolute risk The difference in the risk for disease or death between an exposed difference population and an unexposed population. Absolute risk The difference in the absolute risk (rates of adverse events) between reduction study and control populations. Refers, in a general sense, to the completion of a screening test or Adherence procedure A summarizing procedure for a statistical measure in which the effects Adjustment of differences in composition of the populations being compared have been minimized by statistical methods Statistical dependence between two or more events, characteristics, or other variables. An association may be fortuitous or may be produced Association by various other circumstances; the presence of an association does not necessarily imply a causal relationship. Asymptomatic people are those who do not have one or more Asymptomatic symptoms (e.g., rectal bleeding) that may be due to a disease (e.g., colorectal cancer). Before and after A situation in which the investigator compares outcomes before and study after the introduction of a new intervention. Deviation of results or inferences from the truth, or processes leading Bias to such deviation. Any trend in the collection, analysis, interpretation, Systematic error publication, or review of data that can lead to conclusions that are systematically different from the truth. A study in which observer(s) and/or subjects are kept ignorant of the group to which the subjects are assigned, as in an experimental study, or of the population from which the subjects come, as in a Blind(ed) study nonexperimental or observational study. Where both observer and Masked study subjects are kept ignorant, the study is termed a double-blind study. If the statistical analysis is also done in ignorance of the group to which subjects belong, the study is sometimes described as triple blind. The purpose of "blinding" is to eliminate sources of bias. An epidemiological study involving the observation of cases (persons with the disease, such as colorectal cancer) and a suitable control Case control (comparison, reference) group of persons without the disease. The study relationship of an attribute to the disease is examined by comparing the past history of the people in the two groups with regard to how frequently the attribute is present (= retrospective comparison). Case-series Report of a number of cases of disease. The relating of causes to the effects they produce. Most of epidemiology concerns causality and several types of causes can be Causality distinguished. It must be emphasized, however, that epidemiological evidence by itself is insufficient to establish causality, although it can provide powerful circumstantial evidence. An epidemiological study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed in different degrees, to a factor or factors hypothesised to Cohort study influence the probability of occurrence of a given disease or other outcome. Studies usually involve the observation of either a large population, or for a prolonged period (years), or both.

KCE reports vol.45 Screening for Colorectal Cancer 9 Co-interventions Co-morbidity Comparison group Compliance Confidence interval Confounding Confounding variable, Confounder Continous screening Control event rate Cost-benefit analysis Costeffectiveness analysis Costminimisation analysis Follow-up of exposed and non-exposed defined groups, with a comparison of disease rates during the time covered.) Interventions other than the treatment under study that are applied differently to the treatment and control groups. Cointervention is a serious problem when double blinding is absent or when the use of very effective non-study treatments is permitted. Coexistence of a disease or diseases in a study participant in addition to the index condition that is the subject of study. Any group to which the index group is compared. Usually synonymous with control group. Refers to completion of all tests or examinations when sequential offers are made to the same persons regardless of whether they completed a prior test The range of numerical values in which we can be confident (to a computed probability, such as 95%) that the population value being estimated will be found. Confidence intervals indicate the strength of evidence; where confidence intervals are wide, they indicate less precise estimates of effect. The larger the trial's sample size, the larger the number of outcome events and the greater becomes the confidence that the true relative risk reduction is close to the value stated. Thus the confidence intervals narrow and "precision" is increased. In a "positive finding" study the lower boundary of the confidence interval, or lower confidence limit, should still remain important or clinically significant if the results are to be accepted. In a "negative finding" study, the upper boundary of the confidence interval should not be clinically significant if you are to confidently accept this result. A situation in which the measure of the effect of an exposure on risk is distorted because of the association of exposure with other factor(s) that influence the outcome under study. A third variable that indirectly distorts the relationship between two other variables, because it is independently associated with each of the variables.A variable that can cause or prevent the outcome of interest, is not an intermediate variable, and is associated with the factor under investigation. A confounding variable may be due chance or bias. Unless it is possible to adjust for confounding variables, their effects cannot be distinguished from those of factor(s) being studied. Periodic provision of an opportunity for diagnostic testing to a population of individuals who are asymptomatic and at increased risk for disease (or perception of increased risk) The percentage of the control/nonexposed group who experienced outcome in question. A form of economic evaluation in which an attempt is made to value the consequences or benefits of a medical intervention in monetary terms so that these may be compared with the costs. A form of economic evaluation in which the consequences or benefits of medical interventions are measured in terms of an appropriate health effect, such as life years saved, without placing a monetary value on such effects. These are balanced against the monetary cost of the intervention. A form of economic evaluation in which it can be shown that outcomes are identical and, therefore, only costs are compared. Cost-utility A form of economic evaluation in which the consequences or benefits

<strong>KCE</strong> <strong>reports</strong> vol.45 Screen<strong>in</strong>g for Colorectal Cancer 9<br />

Co-<strong>in</strong>terventions<br />

Co-morbidity<br />

Comparison<br />

group<br />

Compliance<br />

Confidence<br />

<strong>in</strong>terval<br />

Confound<strong>in</strong>g<br />

Confound<strong>in</strong>g<br />

variable,<br />

Confounder<br />

Cont<strong>in</strong>ous<br />

screen<strong>in</strong>g<br />

Control event<br />

rate<br />

Cost-benefit<br />

analysis<br />

Costeffectiveness<br />

analysis<br />

Costm<strong>in</strong>imisation<br />

analysis<br />

Follow-up of exposed and non-exposed def<strong>in</strong>ed groups, <strong>with</strong> a<br />

comparison of disease rates dur<strong>in</strong>g the time covered.)<br />

Interventions other than the treatment under study that are applied<br />

differently to the treatment and control groups. Co<strong>in</strong>tervention is a<br />

serious problem when double bl<strong>in</strong>d<strong>in</strong>g is absent or when the use of<br />

very effective non-study treatments is permitted.<br />

Coexistence of a disease or diseases <strong>in</strong> a study participant <strong>in</strong> addition<br />

to the <strong>in</strong>dex condition that is the subject of study.<br />

Any group to which the <strong>in</strong>dex group is compared. Usually synonymous<br />

<strong>with</strong> control group.<br />

Refers to completion of all tests or exam<strong>in</strong>ations when sequential<br />

offers are made to the same persons regardless of whether they<br />

completed a prior test<br />

The range of numerical values <strong>in</strong> which we can be confident (to a<br />

computed probability, such as 95%) that the population value be<strong>in</strong>g<br />

estimated will be found. Confidence <strong>in</strong>tervals <strong>in</strong>dicate the strength of<br />

evidence; where confidence <strong>in</strong>tervals are wide, they <strong>in</strong>dicate less<br />

precise estimates of effect. The larger the trial's sample size, the larger<br />

the number of outcome events and the greater becomes the<br />

confidence that the true relative risk reduction is close to the value<br />

stated. Thus the confidence <strong>in</strong>tervals narrow and "precision" is<br />

<strong>in</strong>creased. In a "positive f<strong>in</strong>d<strong>in</strong>g" study the lower boundary of the<br />

confidence <strong>in</strong>terval, or lower confidence limit, should still rema<strong>in</strong><br />

important or cl<strong>in</strong>ically significant if the results are to be accepted. In a<br />

"negative f<strong>in</strong>d<strong>in</strong>g" study, the upper boundary of the confidence <strong>in</strong>terval<br />

should not be cl<strong>in</strong>ically significant if you are to confidently accept this<br />

result.<br />

A situation <strong>in</strong> which the measure of the effect of an exposure on risk is<br />

distorted because of the association of exposure <strong>with</strong> other factor(s)<br />

that <strong>in</strong>fluence the outcome under study.<br />

A third variable that <strong>in</strong>directly distorts the relationship between two<br />

other variables, because it is <strong>in</strong>dependently associated <strong>with</strong> each of the<br />

variables.A variable that can cause or prevent the outcome of <strong>in</strong>terest,<br />

is not an <strong>in</strong>termediate variable, and is associated <strong>with</strong> the factor under<br />

<strong>in</strong>vestigation. A confound<strong>in</strong>g variable may be due chance or bias. Unless<br />

it is possible to adjust for confound<strong>in</strong>g variables, their effects cannot be<br />

dist<strong>in</strong>guished from those of factor(s) be<strong>in</strong>g studied.<br />

Periodic provision of an opportunity for diagnostic test<strong>in</strong>g to a<br />

population of <strong>in</strong>dividuals who are asymptomatic and at <strong>in</strong>creased risk<br />

for disease (or perception of <strong>in</strong>creased risk)<br />

The percentage of the control/nonexposed group who experienced<br />

outcome <strong>in</strong> question.<br />

A form of economic evaluation <strong>in</strong> which an attempt is made to value<br />

the consequences or benefits of a medical <strong>in</strong>tervention <strong>in</strong> monetary<br />

terms so that these may be compared <strong>with</strong> the costs.<br />

A form of economic evaluation <strong>in</strong> which the consequences or benefits<br />

of medical <strong>in</strong>terventions are measured <strong>in</strong> terms of an appropriate<br />

health effect, such as life years saved, <strong>with</strong>out plac<strong>in</strong>g a monetary value<br />

on such effects. These are balanced aga<strong>in</strong>st the monetary cost of the<br />

<strong>in</strong>tervention.<br />

A form of economic evaluation <strong>in</strong> which it can be shown that outcomes<br />

are identical and, therefore, only costs are compared.<br />

Cost-utility A form of economic evaluation <strong>in</strong> which the consequences or benefits

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