Dictionary

D

Discriminant ValidityConceptDivergent Validity, Discriminant Construct Validity

Discriminant validity is evidence that a health measure correlates less with measures of other constructs than with its own, as predicted in advance.

DiscriminationTermPredictive Separation, Outcome Distinguishing

The ability of a predictive model or diagnostic test to correctly distinguish between individuals who will and will not experience an outcome.

Discrimination AssessmentTermDiscrimination Evaluation, Discriminative Performance Assessment

An evaluation of a predictive model's ability to distinguish between individuals who will and will not experience a given outcome, often via the ROC curve.

Discrimination BarrierTermDiscriminatory Barrier, Bias-Based Access Barrier

An obstacle to healthcare arising from unfair treatment based on characteristics such as race, ethnicity, or disability, rather than clinical need.

Disease AreaTermCondition Category, Assessment Area

A defined category of medical conditions, such as oncology, used to organise assessment activities and health system planning.

Disease BurdenTermTotal Disease Impact, Population Disease Impact

The total impact of a disease on a population, covering mortality, morbidity, and costs, commonly quantified using disability-adjusted life years.

Disease Control RateTermDCR, Non-Progression Proportion

A cancer outcome measure combining complete response, partial response, and stable disease rates, characterising the proportion whose disease did not progress.

Disease ManagementTermChronic Condition Management, Condition Management Programme

A coordinated programme of interventions improving outcomes for patients with a specific chronic condition, combining education, coordination, and monitoring.

Disease Management ReviewTermDisease Programme Review, Chronic-Care Programme Audit

An evaluation of a disease management programme's effectiveness at improving outcomes and reducing costs for a specific chronic condition.

Disease Model PharmaTermManufacturer Disease Model, Sponsor Disease Model

A decision-analytic or epidemiological model built by a pharmaceutical manufacturer to project a disease's clinical course and a new treatment's expected impact.

Disease PathwayTermDisease Course, Clinical Course Sequence

The sequence of clinical states and events patients with a given condition typically experience over time, from diagnosis through outcome.

Disease PerspectiveTermDisease-Specific Perspective, Condition Perspective

An analytic viewpoint defined by the specific disease being studied, including all relevant costs and outcomes regardless of which payer bears them.

Disease PreventionTermIllness Prevention, Prevention of Disease

Actions taken to reduce the likelihood a disease will occur, progress, or cause complications, covering primary, secondary, and tertiary approaches.

Disease ProgressionTermTumour Growth Progression, Disease Worsening

An increase in tumour size or the appearance of new lesions during or after treatment, indicating the treatment no longer adequately controls the disease.

Disease Severity ClassificationTermSeverity Grading, Severity Categorisation

A formal system categorising disease severity, used within some assessment frameworks to apply differential weighting or thresholds accordingly.

Disease SurveillanceTermEpidemiological Surveillance, Outbreak Monitoring

The ongoing, systematic collection and analysis of health data to monitor disease occurrence and spread within a population, detecting outbreaks.

Disease-Modifying TherapyTermDMT, Course-Altering Treatment

A treatment altering a disease's underlying course or progression, rather than merely treating symptoms, such as certain multiple sclerosis treatments.

Disease-Specific InstrumentTermDisease-Targeted Measure, Disease-Specific Questionnaire

A health status questionnaire capturing outcomes and symptoms relevant to a particular condition, more sensitive to change than a generic instrument.

Disease-Specific QoLTermDisease-Specific Quality of Life, Condition-Specific QoL

A quality of life measure capturing aspects of wellbeing most affected by a particular disease, such as its specific symptom burden.

Diseconomies of ScaleTermRising Average Cost, Scale Inefficiency

A situation in which average cost of production rises as output increases, often due to coordination difficulties or capacity constraints.

DisinvestmentTermDivestment, Funding Withdrawal

The deliberate withdrawal of funding from a healthcare service or technology found to provide low value or since superseded by a better alternative.

Disinvestment FrameworkTermDivestment Framework, Withdrawal Methodology

A structured methodology for identifying, evaluating, and implementing the withdrawal of funding from low-value healthcare services or technologies.

Dispensing PracticeTermMedicine Dispensing, Dispensing Activity

The activities involved in preparing and providing a medication to a patient per a valid prescription, covering verification, preparation, and counselling.

DispersionTermVariability, Spread

A statistical concept describing how spread out or clustered values in a dataset are, commonly measured using variance, standard deviation, or interquartile range.

DisplacementTermForgone Health, Health Opportunity Loss, Displacement Effect

The loss of health benefit elsewhere in a health system that results from allocating resources to a new treatment.

Disproportionate ShareTermDSH, Safety-Net Hospital Payment

A US Medicaid funding mechanism providing additional payments to hospitals serving a disproportionately large share of low-income and uninsured patients.

Disruptive InnovationTermMarket-Disrupting Innovation, Displacing Innovation

An innovation creating a new market by initially serving an overlooked segment with a simpler or cheaper offering, eventually displacing established competitors.

Dissemination ResearchTermDissemination Science, Evidence-Spread Research

A field studying how to effectively spread information about evidence-based interventions to a target audience, increasing knowledge and adoption.

DistressTermEmotional Suffering, Psychological Strain

A clinical outcome measure capturing overall emotional suffering or discomfort, often assessed as broader than specific anxiety or depression symptoms alone.

Distribution FittingConceptFitting Distributions, Distributional Fit

Distribution fitting selects a probability distribution and estimates its parameters from data to represent the frequency of possible values under stated assumptions.

Distribution-Based MIDConceptDistribution-Based MCID, Statistical MID Method

A distribution-based MID is a minimal important difference estimated from score spread or instrument reliability, such as half a standard deviation.

Distributional Analysis PolicyTermPolicy Distributional Analysis, Subgroup Impact Analysis, Equity Analysis Policy

An examination of how a policy's costs and benefits are expected to be distributed across population subgroups, assessing equity implications.

Distributional Cost-EffectivenessConceptDCEA

Distributional cost-effectiveness analysis (DCEA) is an economic evaluation showing who gains and loses health from a policy and its effect on inequality.

Distributive JusticeTermFair Allocation, Justice in Distribution

A branch of ethical and political philosophy concerned with the fair allocation of resources, benefits, and burdens across a society.

DisutilityConceptUtility Loss, Negative Utility

Disutility is the loss of utility caused by a health state, adverse event or treatment, measured from a stated baseline and used to reduce QALYs.

Diverticulitis EconomicsTermDiverticulitis Cost-Effectiveness, Diverticular Disease Economics

The application of health economic evaluation to diverticulitis, comparing outpatient antibiotic management against hospitalisation and, in severe cases, surgery.

DMAICTermDefine Measure Analyse Improve Control, Six Sigma Improvement Cycle

A structured, five-phase Six Sigma methodology, Define, Measure, Analyse, Improve, Control, for identifying and addressing root causes of a quality problem.

DNR OrderTermDo-Not-Resuscitate Order, No-CPR Order

A do-not-resuscitate order, a medical directive instructing providers not to perform CPR if a patient's heart or breathing stops.

Do Not DoTermStop Recommendation, Reversal Recommendation

A formal recommendation identifying a practice or treatment that should no longer be used, evidence indicating insufficient benefit relative to cost or risk.

DOAC EconomicsTermDirect Oral Anticoagulant Economics, NOAC Economics

The application of health economic evaluation to direct oral anticoagulants, comparing higher acquisition cost against reduced monitoring versus older agents such as warfarin.

Documentation ImprovementTermClinical Documentation Enhancement, CDI

An organised programme enhancing clinical documentation completeness and accuracy, typically involving specialists who query physicians for clarification.

DomainTermEvaluation Dimension, Assessment Category

A specific dimension or category within a broader evaluation framework, such as the certainty or consistency domains within GRADE.

DominanceConceptDominant Option

Dominance in cost-effectiveness analysis excludes an option when another option, or a blend of two others, is no worse on cost or effect and better on one.

Dominance AnalysisConceptDominance Screening, Dominated-Option Check

Dominance analysis identifies interventions that are inferior to another feasible option or to the efficient combination of options on cost and health outcome, leaving a frontier for fully incremental comparison.

Dominated AlternativeTermDominated Option, Inferior Alternative

An intervention that is both more costly and less effective than another option, or a combination of options, and so should not be selected.

Donor FundingTermExternal Funding, Donor Aid

Financial resources provided by external organisations, such as development agencies or foundations, to support health programmes, particularly in lower-income countries.

Dosage FormTermDrug Form, Pharmaceutical Presentation

The physical form in which a drug product is manufactured and given to a patient, such as a tablet, capsule, injection, or patch.

Dose CappingTermDose Cap, Payment Cap

A pricing arrangement limiting total payment owed for a treatment regardless of actual dose administered, often used for weight-based dosing.

Dose DelayTermTreatment Postponement, Delayed Dosing

A postponement of a scheduled treatment dose, typically due to toxicity, patient scheduling constraints, or other clinical considerations.

Dose EscalationTermDose-Escalation Study, Escalation Phase

A structured early-phase process progressively increasing an investigational treatment's dose across successive small groups to identify the maximum tolerated dose.