ABFM HALM key terms

The number of patients who must receive an intervention for one additional person to benefit, calculated as the reciprocal of the absolute risk reduction. Lower values indicate greater clinical efficiency.

The arithmetic difference in event rates between a control group and a treated group, expressed as a percentage or proportion. It reflects the actual clinical benefit magnitude rather than a relative comparison.

The proportion of people who truly have a condition and are correctly identified as positive by a test. Highly sensitive tests are useful for ruling out disease when results are negative.

The proportion of people without a condition who are correctly identified as negative by a test. Highly specific tests are useful for confirming disease when results are positive.

The probability that a person with a positive test result actually has the condition. It rises as disease prevalence in the tested population increases.

The apparent survival gain created when screening detects disease earlier without actually postponing death. Survival measured from diagnosis looks longer even when the time of death is unchanged.

A letter rating (A through D or I) assigned by the U.S. Preventive Services Task Force indicating the strength of evidence and net benefit of a preventive service. Grade A and B services are generally covered without cost sharing.

Interventions delivered before disease develops, such as immunizations, smoking cessation counseling, or blood pressure control, intended to reduce the incidence of new disease in a population.

Detecting and treating disease in its early, asymptomatic stage to alter its natural history, such as mammography or colon cancer screening. It aims to reduce morbidity and mortality through early intervention.

Efforts to limit disability and restore function in people with established disease, such as cardiac rehabilitation after myocardial infarction or glycemic control to prevent nephropathy. It focuses on complications rather than incidence.

A collaborative process in which clinician and patient discuss options, benefits, harms, and patient values before choosing a plan. It is central when evidence is equivocal or preference-sensitive.

Measurement of blood pressure over 24 hours with a wearable device, capturing daytime and nighttime readings. It identifies white-coat and masked hypertension and correlates better with cardiovascular outcomes than office readings.

Elevated blood pressure in the clinical setting that normalizes outside the office, confirmed by home or ambulatory monitoring. It generally carries lower risk than sustained hypertension but warrants periodic reassessment.

Categorization of blood pressure into normal, elevated, stage 1, and stage 2 based on systolic and diastolic thresholds. Stage and overall cardiovascular risk determine whether lifestyle change alone or medication is indicated.

A first-line antihypertensive drug class that lowers blood pressure by promoting sodium and water excretion in the distal tubule. It can cause hypokalemia, hyperuricemia, and hyperglycemia and is often combined with other agents.

A drug class blocking angiotensin-converting enzyme, reducing angiotensin II formation and lowering blood pressure. It is preferred in diabetes with albuminuria and chronic kidney disease but is contraindicated in pregnancy and bilateral renal artery stenosis.

A measure of the percentage of glycated hemoglobin reflecting average blood glucose over roughly the prior two to three months. It is used to diagnose and monitor diabetes and to estimate glycemic control.

A state of impaired glucose regulation falling short of diabetes criteria, defined by A1c, fasting glucose, or oral glucose tolerance testing thresholds. It identifies people who benefit from intensive lifestyle programs to prevent progression.

A wearable sensor system that measures interstitial glucose at frequent intervals, showing trends and time in range. It improves glycemic control and reduces hypoglycemia in people treated with insulin.

Loss of the typical warning symptoms of low blood glucose, increasing the risk of severe hypoglycemia. It is more common with longstanding insulin-treated diabetes and requires individualized glycemic targets and education.

Kidney damage caused by diabetes, identified by persistent albuminuria, reduced glomerular filtration rate, or both. Angiotensin blockade and glycemic and blood pressure control slow its progression.

Structured training that helps people with diabetes build skills in monitoring, medication use, nutrition, and problem-solving. It improves glycemic outcomes and is recommended at diagnosis and when changes occur.

A pulmonary function test measuring forced expiratory volumes and flows. A post-bronchodilator FEV1/FVC ratio below a fixed threshold supports the diagnosis of obstructive lung disease such as COPD.

A progressive airflow limitation disorder, most often caused by tobacco smoke, with persistent respiratory symptoms. Management centers on inhaled bronchodilators, smoking cessation, and vaccination.

The degree to which asthma symptoms, rescue inhaler use, nighttime awakenings, and activity limitation are minimized. Poor control prompts step-up therapy, inhaler technique review, and trigger assessment.

The correct sequence of priming, shaking, exhaling, actuating during inhalation, and breath-holding needed for effective drug delivery. Errors are common and contribute to apparent treatment failure.

A nine-item self-report instrument that scores the frequency of depressive symptoms and screens for major depression. It also tracks severity and treatment response over time.

A seven-item self-report questionnaire measuring generalized anxiety symptom severity. Scores help screen for anxiety disorders and monitor response to treatment.

A collaborative counseling style that elicits a person's own reasons for change using open questions, affirmation, reflection, and summarizing. It is effective for substance use, tobacco cessation, and lifestyle change.

A degenerative joint disease with cartilage loss, pain, and stiffness worsened by activity. Management emphasizes exercise, weight loss, and topical or oral analgesics, with surgery reserved for refractory cases.

An algorithm estimating the ten-year probability of major osteoporotic and hip fracture from clinical risk factors, with optional bone density input. It guides decisions about pharmacologic osteoporosis treatment.

Low bone mass and microarchitectural deterioration that raise fracture risk, defined by bone density criteria or prior fragility fracture. Treatment includes calcium, vitamin D, exercise, and antiresorptive or anabolic drugs.

Age-related loss of muscle mass and strength that impairs mobility and raises fall risk. Resistance training and adequate protein intake are key countermeasures.

The concurrent use of multiple medications, often defined as five or more, which increases the risk of interactions and adverse effects. Periodic review and deprescribing are important in older adults.

A list of potentially inappropriate medications for older adults, organized by drug class and clinical concern. It supports safer prescribing and deprescribing decisions.

An ongoing process of discussing and documenting a person's values and preferences for future medical care. It includes health care proxies and advance directives and should be revisited as health changes.

Periodic testing with cytology, HPV testing, or co-testing to detect precancerous cervical changes. Start and stop ages and intervals depend on prior results, risk factors, and guideline recommendations.

Immunization that prevents infection with high-risk HPV types linked to cervical and other cancers. It is recommended in adolescence and for eligible adults who were not previously vaccinated.

Blood testing for PSA used to detect prostate cancer, ideally after shared decision-making about benefits and harms. Harms include false positives, biopsy complications, and overdiagnosis.

Ongoing, longitudinal monitoring of a child's development through history, observation, and parent concerns at every well visit. It differs from formal screening and triggers referral when concerns arise.

Use of validated standardized tools at scheduled ages to identify children at risk for developmental delay. A positive screen prompts further evaluation and early intervention referral.

Brief, repeated advice combined with behavioral support and pharmacotherapy to help patients stop tobacco use. It is one of the most cost-effective preventive interventions in primary care.

An eating pattern emphasizing vegetables, fruits, legumes, whole grains, nuts, olive oil, and fish while limiting red meat and processed foods. It is associated with reduced cardiovascular and metabolic risk.

Lowering salt intake, typically below about 2,300 mg per day, to reduce blood pressure and cardiovascular risk. It is a core lifestyle intervention for hypertension.