Dictionary

D

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

Distress is non-specific psychological suffering, not tied to one disorder, that health surveys and economic evaluations measure with scales like the K10.

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.

DLQIConceptDermatology Life Quality Index

DLQI is a ten-question skin-specific quality of life questionnaire scored 0 to 30, used in dermatology trials and NICE appraisals to define response.

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.

Documentation ImprovementTermClinical Documentation Enhancement, CDI

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

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.

Dose FindingTermDose-Finding Study, Dose Optimisation

The overall process of identifying an appropriate dose or regimen for a new treatment, balancing efficacy against tolerability during early development.

Dose IntensityTermCumulative Dose Rate, Regimen Aggressiveness

The amount of drug given per unit of time, reflecting both dose size and administration interval, a measure of regimen aggressiveness.

Dose Range AlertTermDose Range Check, Out-of-Range Dose Warning

A computerised notification warning a prescriber that a proposed medication dose falls outside a safe range for the patient's characteristics.

Dose ReductionTermDose Lowering, Reduced Dosing

A decrease in the amount of medication given relative to the originally planned dose, typically in response to observed toxicity.

Dose ResponseConceptDose-Effect Relationship, Exposure-Response

Dose response is the relationship between the amount of a drug or exposure and the size or probability of its effect, used in dose selection and HTA.

Dose-Limiting ToxicityTermDLT, Dose-Limiting Adverse Event

A sufficiently severe adverse event in early-phase trials that prevents further dose escalation, used to help determine the maximum tolerated dose.

Double BlindTermDouble-Blind Design, Double-Masked

A trial design in which neither participants nor those administering treatment and assessing outcomes know a given participant's treatment assignment.

Double ProgrammingTermIndependent Reprogramming, Parallel Programming Check

A quality assurance technique in which two analysts independently build the same model, with any discrepancies between the versions investigated and resolved.

DowncodingTermUnder-Coding, Low-Level Code Assignment

The practice of assigning a lower-level, less specific code than the clinical documentation actually supports, whether from error or ambiguity.

Downside RiskTermTwo-Sided Risk, Financial Downside

A feature of a value-based arrangement in which a provider is financially responsible for spending exceeding a benchmark, unlike an upside-only arrangement.

Draft RecommendationTermPreliminary Recommendation, Provisional Decision

A preliminary funding decision issued before a final decision, typically released for public and stakeholder consultation and comment.

DRG AssignmentTermDRG Grouping, Inpatient Group Assignment

The process of classifying an inpatient stay into the appropriate diagnosis-related group category, based on diagnosis, procedures, and other clinical factors.

DRG CreepConceptCode Creep, DRG Upcoding

DRG creep is a rise in recorded hospital case mix, and so in DRG payments, that comes from coding changes rather than from sicker or more complex patients.

DropoutTermStudy Discontinuation, Participant Withdrawal, Withdrawal

The premature discontinuation of a study participant's involvement before planned completion, whether from withdrawn consent, adverse events, or lost contact.

Drug ApprovalTermRegulatory Authorisation Decision, Product Approval

The formal regulatory decision authorising a pharmaceutical product for marketing and clinical use, based on review of safety and efficacy evidence.

Drug ClassificationTermDrug Categorisation, Pharmaceutical Classification

The categorisation of pharmaceutical products by characteristics such as therapeutic use, chemical structure, or regulatory status.

Drug ClearanceTermSystemic Clearance

A pharmacokinetic measure of the rate at which a drug is removed from the body, usually expressed as blood or plasma volume cleared per time.

Drug CompoundingTermCompounding, Pharmaceutical Compounding

The process by which a pharmacist or physician combines or alters ingredients to create a customised medication for an individual patient's needs.

Drug CostTermMedication Cost, Pharmaceutical Cost

The total expense of a pharmaceutical treatment, covering acquisition price and, where relevant, associated administration and monitoring costs.

Drug DevelopmentTermPharmaceutical Development, Medicine Development

The multi-stage process of bringing a new pharmaceutical product from discovery through preclinical testing, clinical trials, and regulatory approval to market.

Drug DiscoveryTermCompound Discovery, Early Discovery

The early drug development stage focused on identifying and characterising new chemical or biological compounds with potential to treat a disease.

Drug Evaluation CommitteeTermDEC, Formulary Committee

A formally constituted expert body responsible for reviewing evidence for a pharmaceutical product and recommending its reimbursement or formulary inclusion.

Drug HolidayTermTreatment Break, Planned Medication Pause

A planned, temporary discontinuation of a medication, used to reduce cumulative toxicity, manage side effects, or assess if treatment remains needed.

Drug InteractionTermConcomitant Drug Effect, Medicine Co-Effect

An alteration in a drug's effect caused by another substance present at the same time, such as another medication, food, or supplement.

Drug Interaction AlertTermDDI Alert, Interaction Warning

A computerised notification warning a prescriber that a proposed medication may interact harmfully with another the patient is already taking.

Drug MetabolismTermBiotransformation, Metabolic Processing

The biochemical process by which the body chemically alters a drug, typically via liver enzymes, into forms more easily eliminated.

Drug PricingConceptPharmaceutical Pricing, Medicine Price Setting

The setting and negotiation of medicine prices and payments across a specified product, purchaser, market and point in the supply chain.

Drug ResistanceTermReduced Drug Susceptibility, Treatment Resistance

A reduction in a treatment's effectiveness over time due to biological adaptation, such as mutation of a pathogen or tumour cell population.

Drug StandardsTermPharmaceutical Standards, Drug Quality Standards

The official specifications governing a medication's identity, quality, purity, and strength, established through a recognised compendium as an authoritative reference.