Diagnosis-related Group (drg): From 1 Different Sources
1 Represents classes of hospital patients with similar clinical characteristics. DRGs form a clinical grouping system which describes hospital discharges according to medical condition. 2 A system used for payment under prospective payment systems. It classifies treatments by diagnosis, measuring the relative complexity of a hospital procedure and accounting for the resources used in the procedure. The system accounts for principal diagnosis, secondary diagnosis, surgical procedures, age, sex and presence of complications.
The process of determining health status and the factors responsible for producing it. It may be applied to an individual, family, group or community. The term is applied both to the process of determination and to its findings. See also “principal diagnosis”.... diagnosis
Psychotherapy in which at least two, but more commonly up to ten, patients, as well as the therapist, take part. The therapist encourages the patients to analyse their own and the others’ emotional and psychological diffculties. Group therapy is also used to help patients sharing the same condition – for instance, alcoholism or compulsive gambling. They discuss their problems for perhaps an hour twice a week and explore ways of resolving them.... group therapy
A variety of chronic symptoms and physical findings that occur in some persons who are infected with HIV, but do not meet the Centres for Disease Control’s definition of AIDS. Symptoms may include chronic swollen glands, recurrent fevers, unintentional weight loss, chronic diarrhoea, lethargy, minor alterations of the immune system (less severe than those that occur in AIDS), and oral thrush. ARC may or may not develop into AIDS.... aids-related complex
A list of the possible diagnoses that might explain a patient’s symptoms and signs, and from which the correct DIAGNOSIS will be extracted after further investigations.... differential diagnosis
A formal association of three or more health practitioners or other health professionals providing health services. Income from the practice is pooled and redistributed to the members of the group according to some prearranged plan.... group practice
The group of persons for whom an intervention is planned. For example, the targeting of services to particular user groups.... targeting / target population / target group
A category in a classification or typology of clients. Clients can be classified in various dimensions, e.g. by dependency level, by diagnosis.... client group
The use of information technology to assist health care professionals in diagnosis. This usually involves a dialogue between a computer system and a clinician. The systems are generally regarded as support systems for clinicians; the final responsibility for decision-making resides with the clinician.... computer-assisted diagnosis
A group of participants that serves as the basis of comparison when assessing the effects of the intervention of interest that is given to the participants in the treatment group. Depending upon the circumstances of the trial, a control group may receive no treatment, a ‘usual’ or ‘standard’ treatment, or a placebo. To make the comparison valid, the composition of the control group should resemble that of the treatment group as closely as possible.... control group
A system used for payment under prospective payment systems. It classifies treatments by diagnosis, measuring the relative complexity of a hospital procedure and accounting for the resources used in the procedure. The system accounts for principal diagnosis, secondary diagnosis, surgical procedures, age, sex and presence of complications.... diagnosis-related group
A type of group discussion that is designed to elicit information about the wants, needs, viewpoints, beliefs and experiences of the intended audience. Focus groups can aid in better understanding the expressions and terminology commonly used by people in the audience, as well as their attitudes and beliefs about health care. They are useful for helping uncover the reasons behind people’s responses.... focus group
A house in which people have their own rooms but there are communal facilities. Staff may live in to offer support.... group home
See “assisted living facility”.... group senior assisted housing
Individual outcome measure that extends beyond traditional measures of mortality and morbidity to include such dimensions as physiology, function, social activity, cognition, emotion, sleep and rest, energy and vitality, health perception and general life satisfaction (some of these are also known as health status, functional status or quality-of-life measures).... health-related quality-of-life (hrql) measure
A list of diagnoses and identifying codes used by medical practitioners and other health care providers. The coding and terminology provide a uniform language that permits consistent communication on claim forms. Data from earlier time periods were coded using the appropriate revision of the ICD for that time period. Changes in classification of causes of death in successive revisions of the ICD may introduce discontinuities in cause of death statistics over time.... international statistical classification of diseases and related health problems, tenth revision (icd-10)
People who share a cultural heritage which is different from the majority ethnic culture. See also “ethnicity”; “culture”.... minority ethnic group
A face-to-face group judgement technique in which participants generate silently, in writing, responses to a given question/problem; responses are collected and posted, but not identified by author, for all to see; responses are openly clarified, often in a round robin format; further iterations may follow; and a final set of responses is established by voting/ranking.... nominal group technique
The medical condition that is ultimately determined to have caused a person’s need for medical care. The principal diagnosis is used to assign every person to a diagnosis-related group. This diagnosis may differ from the admitting and major diagnoses. See also “diagnosis”.... principal diagnosis
Prenatal screening of fetal abnormalities may be the result of screening tests carried out on most or all pregnant women, or as the result of speci?c diagnostic tests performed to detect speci?c conditions. Prenatal diagnosis is important as it will identify babies who might need medical or surgical treatment before or soon after birth. In addition, it may also detect severe abnormalities for which parents might decide to have a therapeutic ABORTION.
ULTRASOUND scanning is probably the most widely used diagnostic tool in obstetric practice. It can detect structural abnormalities such as SPINA BIFIDA and CLEFT PALATE and even cardiac and renal problems. A series of scans can assess whether the baby is growing at a normal rate; ultrasound may also be used to assist with other diagnostic tests (e.g. AMNIOCENTESIS – see below).
Tests on the mother’s blood can also diagnose fetal abnormalities. Alphafetoprotein (AFP) is produced by babies and ‘leaks’ into the AMNIOTIC FLUID and is absorbed by the mother. In spina bi?da and other neural-tube defects there is increased leakage of AFP, and a blood test at 16 weeks’ gestation can detect a raised level which suggests the presence of these abnormalities.
The triple test, also performed at 16 weeks, measures AFP and two hormones – HUMAN CHORIONIC GONADOTROPHIN and unconjugated OESTRADIOL – and is used in diagnosing DOWN’S (DOWN) SYNDROME.
Amniocentesis involves inserting a needle through the mother’s abdominal wall into the uterus to remove a sample of amniotic ?uid at 16–18 weeks. Examination of the ?uid and the cells it contains is used in the diagnosis of Down’s syndrome and other inherited disorders. The test carries a small risk of miscarriage.
Chorionic villus sampling may be used to diagnose various inherited conditions. A small amount of tissue from the developing PLACENTA is removed for analysis: this test has the advantages of having a lower incidence of miscarriage than amniocentesis and is carried out at an earlier stage (9–13 weeks).
Analysis of a blood sample removed from the umbilical cord (cordocentesis) may diagnose infections in the uterus, blood disorders or inherited conditions.
Direct observation of the fetus via a viewing instrument called a fetoscope is also used diagnostically and will detect structural abnormalities.
Most tests have a recognised incidence of false positive and negative results and are therefore usually cross-checked with another test. Counselling of the parents about prenatal tests is important. This allows them to make an informed choice which may not necessarily involve terminating the pregnancy if an abnormality is found. (See PREGNANCY AND LABOUR.)... prenatal screening or diagnosis
Any set of persons within society with particular demographic, economic or social characteristics.... social group
A group of people who share a common bond (e.g. caregivers, patients, families of patients) who come together on a regular basis to share problems and experiences or keep in contact in other ways (e.g. the Internet).... support group
A form of arthritis running concurrently with a bowel disorder arising from intestinal irritation. Acute Crohn’s disease or colitis may be related. Joint stiffness and inflammation subside on disappearance of the bowel condition.
Chronic bowel conditions are frequently responsible for heavy drainage of vitamins and minerals via excessive stool. Calcium may be pillaged from the bones to make up blood calcium levels which, if prolonged, may lead to rigid spine.
Treatment. Treatment of arthritis would be secondary, the primary object being to normalise the bowel. Alternatives:–
Teas or decoctions. Comfrey leaves, Calamus, Chamomile, Avens, Agrimony, Marshmallow root, Meadowsweet, Slippery Elm bark, Wild Yam.
Tea. Formula. Equal parts: Agrimony, Balm, Chamomile. 1 heaped teaspoon to each cup boiling water; infuse 5-10 minutes; 1 cup freely.
Fenugreek seeds. Decoction. 1 cup freely.
Tablets/capsules. Calamus, Fenugreek, Goldenseal, Wild Yam.
Formula. Fenugreek 2; Wild Yam 1; Goldenseal quarter; Ginger quarter. Mix. Dose: Powders: 500mg (two 00 capsules or one-third teaspoon). Liquid extracts: 1 teaspoon. Tinctures: 2 teaspoons.
Bamboo powder. Two 320mg capsules thrice daily. (Dr Max Rombi)
Biostrath Willow Formula.
Diet. Slippery Elm food. Vitamin B12. Low fat. Cider vinegar.
Supportive: high enemas. Natural lifestyle. Outlook good. ... arthritis – bowel related
(AMD, ARMD) see macular degeneration.... age-related macular degeneration
see prenatal diagnosis.... antenatal diagnosis
any one of a variety of conditions involving the *pleura, but not the lungs (see asbestosis), in subjects exposed to asbestos. These include the formation of pleural plaques, diffuse pleural thickening, and pleural effusions (see oedema).... asbestos-related pleural disease
Blood group of people donor can receive blood from... donor’s blood group
(in Britain) any of the groups that work with NHS foundation trusts to represent the views of patients and other interested parties in setting the strategic direction of the trust. They are often formed around specific disease categories or patient groups (e.g. deaf patients, children in care).... community interest group
the coexistence of a severe mental disorder with a *substance misuse disorder.... dual diagnosis
(GBS) a Gram-positive bacterium that causes life-threatening infections in newborn infants following vaginal delivery (see Streptococcus; Lancefield classification). 20% of pregnant women are carriers and have no symptoms; however, *vertical transmission of the bacterium from mother to fetus at the time of delivery may lead to neonatal sepsis, characterized by pneumonia, meningitis, and death in some cases. Antibiotic prophylaxis with penicillin during labour is recommended for women with risk factors or who are known to be carriers.... group b streptococcus
(NIPD) see prenatal diagnosis.... noninvasive prenatal diagnosis
(PTH-RP) a protein that is secreted by certain malignant tumours and is the main cause of malignant *hypercalcaemia. PTH-RP, which has effects similar to *parathyroid hormone, stimulates generalized bone resorption and excessive calcium reabsorption in the kidney tubules. It is most commonly produced by lung tumours, squamous-cell carcinomas of other organs, melanomas, and tumours of the breast, liver, pancreas, bladder, and prostate.... parathyroid hormone-related protein
a technique for improving the sensitivity and specificity of bladder cancer diagnosis at cystoscopy using a light-sensitive agent. This agent is instilled into the bladder, taken up by the epithelial cells, and converted into a porphyrin that accumulates only in malignant and premalignant cells. It fluoresces under light of a specific wavelength and is thus highlighted against normal bladder mucosa.... photodynamic diagnosis
see National Statistics Socio-economic Classification.... socio-economic group
(PGD) a diagnostic procedure carried out on embryos at the earliest stage of development, before implantation in the uterus. Access to these early embryos requires the *in vitro fertilization of egg cells: three days after fertilization one or two cells are aspirated from the six-cell embryo; alternatively, tissue is removed from an embryo at five or six days, when it has reached the *blastocyst stage. Isolated cells can then be genetically analysed, allowing the transfer of selected embryos to the mother. One of the major applications of PGD is for the detection (using the *FISH technique) of chromosomal abnormalities, especially *aneuploidies (e.g. Down’s syndrome); the procedure is used mainly in women who have had repeated miscarriages or have failed to achieve pregnancy after several IVF treatment cycles, which could be due to the presence of such abnormalities in the embryo. PGD can also be used to detect defective genes responsible for hereditary disorders (e.g. the commonest form of cystic fibrosis, Huntington’s disease) and genes associated with susceptibility to certain cancers. When a defect is detected, *genetic counselling is offered.... preimplantation genetic diagnosis
(antenatal diagnosis) diagnostic procedures carried out on pregnant women in order to detect the presence of genetic or other abnormalities in the developing fetus. Ultrasound scanning (see ultrasonography) remains the cornerstone of prenatal diagnosis. Other procedures include chromosome and enzyme analysis of fetal cells obtained by *amniocentesis or, at an earlier stage of pregnancy, by *chorionic villus sampling (CVS). Noninvasive prenatal diagnosis involves a blood test to analyse cell-free fetal DNA in maternal blood. It can be performed during the first trimester and is used for fetal rhesus (Rh) determination in Rh-negative mothers, fetal sex determination in pregnancies at risk of sex-linked disorders, and for some single-sex gene disorders (e.g. achondroplasia). Compare prenatal screening.... prenatal diagnosis
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