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Glossary


Alcohol specific conditions (or wholly attributable): Includes those conditions where alcohol is implicated in all cases of the condition (e.g Alcohol Liver Disease is alcohol specific and has an Alcohol Attributable Fraction of 1, because no cases would arise without alcohol).

Alcohol attributable (or partially attributable): Alcohol-attributable conditions include all those where alcohol is causally implicated in some but not all cases of the condition, for example, hypertensive diseases (high blood pressure), various cancers and falls. The attributable fraction for alcohol-attributable conditions ranges from between greater than zero and less than one. For example, the Alcohol-Attributable Fraction for assault is 0.27.

Allied health professionals: Health care professionals other than doctors
and nurses. Includes groups such as physiotherapists, occupational therapists etc. (also known as professions allied to medicine or PAMs.)

All Age, All Cause, All Mortality (AAACM): This is a rate which is used to check how we are performing against the Public Sector Agreement (PSA) target to improve the health of the population and reduce inequalities. The target states we must, “reduce by at least 10% the gap in life expectancy between the fifth of areas with the worst health and deprivation indicators and the population as a whole by 2010”. The All Age All Cause Mortality (AAACM) rate per 100,000 is used on an annual basis to evaluate local progress against this target.

Baseline: The situation before the introduction of any treatment used as a comparison with the, ‘after’ period, so that the effects of any treatment can be observed.

BME Groups: Black and Minority Ethnic Groups.

Case study: A detailed analysis of an individual programme or person. Case studies may be performed on several programmes simultaneously to allow qualitative comparisons of aspects of the programs.

Clinical effectiveness: How well a drug, treatment or package of care works to produce good outcomes for patients.

Clinician: A health care professional providing patient care, eg a doctor, nurse or physiotherapist.

Cochrane Library: The Cochrane Library consists of a regularly updated collection of evidence-based 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 on the internet.

Commissioning: Process in which health services and local authority agencies identify local needs for services and assess them against available public, private and voluntary sector funding. Priorities are decided and services are purchased from the most appropriate providers through contracts and service agreements. As part of the commissioning process services are subject to regular evaluation.

Cost effectiveness: Value for money. A specific health care treatment is said to be 'cost-effective' if it gives a greater health gain than could be achieved by using the resources in other ways.

Cost-benefit analysis: A type of economic evaluation where both costs and benefits of health care treatment are measured in the same monetary units. If benefits exceed costs, the evaluation would recommend providing the treatment.

Confidence Intervals (CI): confidence intervals give an idea about how accurate a value really is. Wide confidence intervals indicate a lack of certainty, whereas narrow confidence intervals indicate more precise estimates. It is most commonly expressed as two values with ‘CI 95%’ shown after them, which means we are 95% confident that the true effect lies within the two values.

Confounding factor: Something that introduces uncertainty and bias into an observed outcome, complicating interpretation.

Correlation: A statistical measure which tells us how associated or related different variables are to each other.

Data analysis: The process of systematically applying statistical and logical techniques to describe, summarise, and compare data collected.

Database: An accumulation of information that has been systematically organised for easy access and analysis, for example in Access.

Demographics: The statistical characteristics of human populations such as age, race, ethnicity, and sex.

Dependent drinking: A pattern of consumption characterised by psychological dependence, often with an increased drive to use alcohol and difficulty controlling its use. Symptoms of dependence including impaired control or a subjective experience of a compulsion to drink are experienced. In the extreme, it is associated with physical withdrawal symptoms upon cessation.

Deprived areas: Regions or areas characterised by significantly higher levels of unemployment and lower rates of income per head compared with the national average.

Determinants of health: The wide range of personal, social, economic and environmental factors which determine the health status of people or communities. They include health behaviours and lifestyles, income, education, employment, working conditions, access to health services, housing and living conditions and the wider general environment.

Directly Standardised Rates (DSR): The overall rate that would occur in a standard population age-structure if it experiences the age-specific rates of the observed population.

Effectiveness: The extent to which a specific treatment or intervention, when used under usual or everyday conditions, does what it is intended to do, eg control or cure an illness. (Clinical trials that assess effectiveness are sometimes called ‘management trials’.)

Elective: Non-urgent clinical procedures

Epidemic: A disease that spreads rapidly through a segment of the human population, such as everyone in a given geographic area; a military base, or similar population unit; or everyone of a certain age or sex, such as the children or women of a region. Epidemic diseases can be spread from person to person or from sources such as food or water.

Epidemiology: The study of the distribution and determinants of health and disease and applying this knowledge to the prevention and control of health issues.

Evaluation: Assessing if an intervention (for example a treatment, service, project, or programme) achieves its aims. The results of evaluations can help in decision-making and in planning future policies. Process evaluation is an ongoing examination of the intervention from its conception to its delivery and includes staff performance, methods, activities, effectiveness and efficiency. Outcome evaluation is an assessment of the immediate or midterm effects of an intervention or some aspect of an intervention.

Evidence based: The process of systematically finding, appraising, and using research findings as the basis for clinical decisions.

Freedom of Information (FOI): The Freedom of Information (FOI) Act was passed on 30 November 2000 and gives a general right of access to all types of recorded information held by public authorities. The intention of the Act is to encourage a spirit of openness and transparency in the NHS and to let the public see how we organise and deliver our services and NHS Wirral fully support this aim. For further details please refer to NHS Wirral’s FOI policy.

Hazardous drinking: A pattern of alcohol consumption associated with a high risk of psychological or physical problems in the future. The Scottish Intercollegiate Guidelines Network (SIGN) guideline defines hazardous drinking as regular consumption of 5+ units per day for men, and 3 for women

Harmful drinking: A pattern of alcohol consumption that is already causing damage to physical or mental health. Harmful drinkers often already show clear evidence of harm by experiencing, for example, gastrointestinal complications, insomnia or falls. They typically consume more than hazardous drinkers and above recommended levels.

Health Needs Assessment: A systematic method for reviewing the health and wellbeing needs of a population. Usually conducted so that organisations can agree commissioning priorities that will improve the health and wellbeing outcomes and reduce inequalities in their populations.

Health Equity Audit: a systematic process for reviewing inequalities in the causes of ill health and access to effective services for a defined population. The outcome should be to ensure that findings result in actions to reduce inequalities that are agreed and incorporated into policy, plans and practice.

Health inequalities: The gap in health status and in access to health services, between different social classes and ethnic groups, and between populations in different geographical areas. For more information, see Department of Health website: www.dh.gov.uk/healthinequalities

Incidence: The number of new cases of a disease that occur in a specified population during a specified time period.

Index of Multiple Deprivation (IMD): The Index of Multiple Deprivation takes a number of factors covering a range of health, economic, social and housing issues and combines them into a single deprivation score for each small area in England. This allows areas to be ranked according to their level of deprivation. The Indices of Deprivation was calculated in 1999, 2002, 2004 and most recently in 2007.

Indirectly Standardised Rates: The ratio of the observed number of events that would be expected if age-specific rates were applied to the particular population’s age structure. A common example is the standardised mortality ratio (SMR).

Intervention: Health care action intended to benefit the patient, eg prescription drugs, surgical procedures, psychological therapy etc.

Local Area Agreements (LAAs): are three-year action plans for achieving better outcomes, developed by councils with their partners (usually health partners in local strategic partnerships (LSP). LAAs for 2008-11 include a mix of national and local priorities and targets, relevant to the area.

Life expectancy: the average length of life of individuals in a population.

Lower Super Output Area (LSOA): There are 32,482 Lower Super Output Area’s in the country, each LSOA equates to roughly around 1,500 people. There are 207 LSOA’s in Wirral.

Low income: This is defined within the 2001 Census as a household with below 60% of median disposable income. In 2002/03, 17% of the population lived in households with income below this level (£194 per week).

Living Wage: Currently (as of December 2013) £7.65 an hour in the UK (£8.80 in London). The Living Wage is a voluntary rate of hourly pay which is independently set according to the basic cost of living in the UK and was set up to address the issue of in-work poverty.

Mortality: The ratio of the total number of deaths to the total population.

Mosaic: Mosaic is a geo-demographic population classification tool which can be used to segment the population according to the type of neighbourhood in which they live. It is constructed from a range of data sources including the Census, consumer behaviour and lifestyle factors and is a useful tool for gaining more in-depth insight into the behaviour and beliefs of the population. Mosaic segments the population into 11 Groups and 61 Types, based on postcode.

National Institute for Clinical Excellence (NICE): NICE is a special health authority responsible for providing patients, health professionals and the public with authoritative, robust and reliable guidance on current ‘best practice’.

Objectives: What you plan to do with your proposed program within the given period

Open-ended questions: Questions in an interview or survey format that allow respondents to answer as they choose, rather than having to select a predefined alternative

Partially Attributable Alcohol Conditions: see Alcohol Attributable Conditions

P value: P values tell us whether an effect can be regarded as statistically significant or not. So if a study is done to compare two treatments then the P value is the probability of obtaining the results of that study. The assumption that there is no difference between treatments is called the 'null hypothesis'. If a P-value is P=0.03, this means is that if there really was no difference between treatments then there would only be a 3% chance of getting the result obtained. Since this chance seems quite low, we would probably conclude that there probably is a difference between treatments. Usually, where the P-value is below 0.05 (i.e. less than 5%) the result is seen as statistically significant. Where the value of P is 0.001 or less, the result is seen as highly significant.

Pilot (test/programme/project): A ‘trial run’ on a small scale to assess the appropriateness and practicability of the test/programme/project. For example, testing (piloting) a new questionnaire with people who are similar to the population of the study, in order to highlight any problems or areas of concern, which can then be addressed before the full-scale study begins.

Population projections: Calculations which show potential future population figures, based on current and previous population figures.

Prevalence: The total number of persons living with a specific disease or condition.

Primary care: Health care delivered to patients outside hospitals. Primary care covers a range of services provided by GPs, nurses and other health care professionals, dentists, pharmacists and opticians.

Probability: How likely an event is to occur, eg how likely a treatment or intervention will alleviate a symptom.

Public Service Agreement (PSA): Public Service Agreements are the Government's high-level priorities. They set out the improvements that the Government wants to achieve and the performance indicators which will be used to measure progress. Each PSA is underpinned by a Delivery Agreement which outlines how improvements will be achieved, and who will be accountable for delivery.

Qualitative data: Data presented in narrative form, such as the information collected from focus groups or key informant interviews.
Quantitative data: Data presented in numerical terms, such as survey data and data from epidemiologic reports.

Qualitative research: Qualitative research is used to explore and understand people's beliefs, experiences, attitudes, behaviour and interactions. It generates non-numerical data, e.g. a patient's description of their pain rather than a measure of pain. In health care, qualitative techniques (such as focus groups and in depth interviews) are commonly used in research documenting the experience of chronic illness and in studies about the functioning of organisations.

Quality adjusted life years (QALYS): A measure of health outcome which looks at both length of life and quality of life. QALYS are calculated by estimating the years of life remaining for a patient following a particular care pathway and weighting each year with a quality of life score (on a zero to one scale). One QALY is equal to one year of life in perfect health, or two years at 50% health, and so on. For example, QALY’s are helpful to organisations such as NICE when they are deciding whether new treatments are clinically and cost-effective.

Quantitative research: Research that generates numerical data or data that can be converted into numbers, for example clinical trials or the national Census which counts people and households.

Relative Risk (RR): The ratio of two risks, usually the risk of a disease in a group of individuals exposed to some factor, divided by the risk in unexposed individuals.

Representative: This means that a sample is similar to the population from which it was drawn, and therefore can be used to draw conclusions about that population.

Research and Development: Developing evidence to inform and underpin health and social care policy and commissioning research focused on the needs of patients and the public.

Sample: A group of subjects selected from a total population with the expectation that studying the group will provide important information about the total population.

Secondary care: Care provided in hospitals.

Social marketing: The use of marketing principles and techniques for the social good. For example, by attempting to influence a target audience to voluntarily accept, reject, modify or abandon a behaviour for the benefit of themselves and/or society as a whole.

Standardised Mortality Ratio (SMR): A ratio of the observed number of deaths in a population, relative to the expected number of deaths in that population. It is calculated by dividing the observed number of deaths by the expected number of deaths for Wirral. Ratios above 100 indicate that the number of events observed was greater than expected, whilst ratios below 100 that it was lower (England average is always 100).

Statistically significant: A measure of whether an observed difference or relationship is larger or smaller than would be expected to occur by chance alone; statistical results are often considered to be significant if there is less than a 5% chance that they would have occurred by chance alone.

Surveillance: The ongoing and systematic collection, analysis, and interpretation of data about health, disease or health conditions.

Synthetic Estimates: Used when ‘real’ data is unavailable or when national surveys (such as the Health survey for England) is too small to provide reliable estimates, synthetic estimates are calculated using statistical modelling techniques.

Systematic Reviews: A systematic review is a literature review focused on a single question which tries to identify, appraise, select and synthesise all high quality research evidence relevant to that question. Systematic reviews are generally regarded as the highest level of medical evidence by evidence-based medicine professionals. An understanding of systematic reviews and how to implement them in practice is fundamental for professionals involved in the delivery of health care.

Target populations: Groups of people who are to be reached through some action or intervention. Groups are often defined based on a combination of characteristics such as race or ethnicity, age, gender, risk factor/behaviour, and geographic location.

Trust: A trust in an NHS organisation responsible for providing a group of health care services. An acute trust provides hospital services. A mental health trust provides most mental health services. A primary care trust buys hospital care on behalf of the local population, as well as being responsible for the provision of community health services.

Validity: The extent to which a survey question or other measurement instrument actually measures what it is supposed to measure; for example, a question that asks young adults how often they use a condom is valid if it accurately measures their actual level of condom use.

Variable: A characteristic of finding that can change or vary among different people or in the same person over time; for example, race or ethnicity varies among individuals, and income varies for the same individual over time.

Well-being: A concept combining an individual’s health, their quality of life, and their satisfaction.

Wholly Attributable Alcohol Conditions: see Alcohol Specific Conditions