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Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.
A retrospective cohort study, also called a historic cohort study, is a longitudinal cohort study used in medical and psychological research. A cohort of individuals that share a common exposure factor is compared with another group of equivalent individuals not exposed to that factor, to determine the factor's influence on the incidence of a ...
Cohort studies can be retrospective (looking back in time, thus using existing data such as medical records or claims database) or prospective (requiring the collection of new data). [3] Retrospective cohort studies restrict the investigators' ability to reduce confounding and bias because collected information is restricted to data that ...
Retrospective drug utilization review refers to drug therapy review that after patients have got the medication. [10] The retrospective drug utilization review has a typical process. [12] This is a computer based review. Computer will show data which are in violation of the standard.
Retrospective cohort study A research study in which the medical records of groups of individuals who are alike in many ways but differ by a certain characteristic (for example, female nurses who smoke and those who do not smoke) are compared for a particular outcome. Also called a historic cohort study. (NCI) Retrospective study
The observational interpretation fallacy is the cognitive bias where associations identified in observational studies are misinterpreted as causal relationships.This misinterpretation often influences clinical guidelines, public health policies, and medical practices, sometimes to the detriment of patient safety and resource allocation.
A retrospective diagnosis (also retrodiagnosis or posthumous diagnosis) is the practice of identifying an illness after the death of the patient (sometimes a historical figure) using modern knowledge, methods and disease classifications.
The PICO process (or framework) is a mnemonic used in evidence-based practice (and specifically evidence-based medicine) to frame and answer a clinical or health care related question, [1] though it is also argued that PICO "can be used universally for every scientific endeavour in any discipline with all study designs". [2]