ABPS Family Medicine (BCFM) key terms

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

The arithmetic difference in event rates between a control group and a treated group, expressed as a percentage or proportion. It reflects the true clinical impact of a therapy rather than its relative effect.

The ratio of the probability of an outcome in an exposed or treated group to the probability in an unexposed or control group. It conveys strength of association but not the baseline magnitude of risk.

A measure of association comparing the odds of exposure among cases to the odds of exposure among controls, commonly used in case-control studies. It approximates relative risk when the outcome is rare.

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

The proportion of people who truly do not have a condition and are correctly identified by a test as negative. 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 disease. It rises as disease prevalence in the tested population increases, even when test sensitivity and specificity stay constant.

The performance features of a test used to detect disease in asymptomatic people, including sensitivity, specificity, and predictive values. A good screening test must also be acceptable, safe, and lead to effective treatment.

The false appearance of prolonged survival that occurs when a disease is detected earlier by screening without actually postponing death. Measured survival lengthens simply because diagnosis happened sooner.

The overestimation of screening benefit that arises because slow-growing, less aggressive disease is more likely to be detected, while rapidly progressive disease is missed between screening intervals.

An observational design that starts with people who have an outcome and compares their past exposures with those of matched people without the outcome. It is efficient for rare diseases but vulnerable to recall bias.

Distortion of study results caused by how participants are chosen or retained, so that groups differ in ways unrelated to the exposure being studied. It threatens the validity of both observational and interventional research.

A third factor associated with both the exposure and the outcome that distorts the observed relationship between them. Randomization, restriction, matching, and statistical adjustment are strategies to control it.

An analytic approach that assigns participants to groups based on their original randomization regardless of whether they completed or adhered to the assigned treatment. It preserves randomization and gives a realistic estimate of effectiveness.

A hierarchy ranking study designs by their susceptibility to bias, from systematic reviews of randomized trials at the top to expert opinion and bench research at the bottom. It guides how much confidence to place in a recommendation.

Systematically developed statements that synthesize evidence to assist clinicians and patients in making decisions about appropriate health care for specific circumstances. They should be adapted to individual patient values.

A collaborative process in which the clinician explains options, risks, and benefits while the patient articulates values and preferences, leading jointly to a chosen plan of care. It is central to patient-centered practice.

The process of obtaining a patient's voluntary agreement to a test or treatment after disclosing its nature, risks, benefits, alternatives, and the consequences of refusal. It requires decision-making capacity and freedom from coercion.

A patient's ability to understand relevant information, appreciate the situation and consequences, reason about options, and communicate a consistent choice. It is assessed for a specific decision rather than as a global trait.

A written statement, such as a living will or durable power of attorney for health care, made while a patient has capacity to guide future care if they later lose the ability to decide.

The concurrent use of multiple medications, often defined as five or more, which raises the risk of adverse drug events, interactions, and nonadherence. Regular medication reconciliation and deprescribing reduce these harms.

A published list of medications considered potentially inappropriate for older adults because of high risk of adverse effects or limited benefit. It supports safer prescribing and medication review in geriatric care.

The systematic, supervised process of reducing or stopping medications that no longer provide benefit, are causing harm, or conflict with a patient's goals. It is a core component of geriatric medication management.

A multidimensional, interdisciplinary evaluation of an older adult's medical, functional, cognitive, psychological, and social status. It produces a coordinated care plan intended to improve outcomes and preserve independence.

Basic self-care tasks such as bathing, dressing, toileting, transferring, continence, and feeding. Difficulty with these tasks signals functional dependence and prompts evaluation for support services.

More complex tasks needed to live independently, including managing finances, shopping, cooking, using transportation, and handling medications. Impairment often precedes loss of basic self-care ability.

A state of increased vulnerability to stressors resulting from declines in physiologic reserve across multiple systems. It predicts falls, hospitalization, disability, and mortality and shapes goals of care.

A structured evaluation of gait, balance, strength, vision, medications, and home hazards to identify older adults likely to fall. Positive screening leads to multifactorial intervention such as exercise and medication review.

A brief, scored cognitive screening tool assessing orientation, registration, attention, recall, language, and visuospatial function. Scores must be interpreted in light of education and language.

An acute, fluctuating disturbance of attention and awareness, often triggered by infection, medications, pain, or metabolic derangement. It is a medical emergency requiring identification and treatment of the underlying cause.

Use of a validated questionnaire such as the PHQ-9 to detect depressive symptoms in at-risk or general populations. Positive screens require clinical confirmation and assessment of suicide risk.

A structured clinical inquiry into suicidal ideation, intent, plan, means access, prior attempts, and protective factors. It guides level of care, safety planning, and referral decisions.

Legal detention of a person for psychiatric evaluation or treatment without consent when they pose a danger to self or others or are gravely disabled. Criteria and procedures are defined by state law.

A collaborative, goal-oriented counseling style that elicits and strengthens a patient's own reasons for change by exploring ambivalence with empathy and without confrontation. It is widely used for substance use and lifestyle change.

A model describing readiness to alter behavior through precontemplation, contemplation, preparation, action, and maintenance. Interventions are matched to the patient's current stage to reduce resistance.

A public health approach that screens patients for risky substance use, delivers short counseling to those identified, and refers those needing further care to specialized treatment. It is feasible in primary care settings.

The recommended timing and dosing of vaccines for children and adolescents, updated annually by national advisory bodies. It accounts for age, contraindications, and catch-up needs.

Indirect protection of unvaccinated individuals that occurs when a sufficiently high proportion of a population is immune, reducing transmission. Thresholds vary by pathogen contagiousness.

A condition that makes vaccination inadvisable because of substantial risk, such as severe allergy to a component or, for live vaccines, significant immunosuppression. Precautions differ from true contraindications.

Expected functional skills in motor, language, cognitive, and social domains that most children achieve by a given age. Delays in one or more domains prompt further evaluation and early intervention referral.

A scheduled preventive pediatric encounter combining growth measurement, developmental surveillance, physical examination, immunization, anticipatory guidance, and screening. Its frequency changes with the child's age.

Inadequate physical growth in a child, often indicated by weight falling across percentile lines or persistently below expected norms. Causes include inadequate intake, malabsorption, and psychosocial factors.

A pregnancy-specific disorder of new hypertension after 20 weeks' gestation with proteinuria or end-organ dysfunction. It requires close monitoring and timely delivery to prevent maternal and fetal complications.

Glucose intolerance first recognized during pregnancy, typically detected by oral glucose tolerance testing at 24 to 28 weeks. Management with diet, activity, and sometimes medication reduces maternal and neonatal complications.

Tests offered during pregnancy to estimate the risk of fetal aneuploidy, neural tube defects, or other conditions, including serum analytes, ultrasound, and cell-free DNA. Screening differs from diagnostic testing.

Excessive blood loss after delivery, commonly defined as more than 500 mL after vaginal birth or 1000 mL after cesarean. Uterine atony is the most frequent cause and requires prompt uterotonic treatment.

The rapid sorting of patients by acuity to prioritize care when demand exceeds resources. It uses standardized scales and is distinct from making a diagnosis.

A prioritized sequence for assessing and treating critically ill patients: airway, breathing, circulation, disability, and exposure. Each step is addressed before moving to the next.

Life-threatening organ dysfunction caused by a dysregulated host response to infection. Early recognition, cultures, broad-spectrum antibiotics, and fluid resuscitation improve survival.

A spectrum of myocardial ischemia including unstable angina and myocardial infarction, often presenting with chest pain, dyspnea, or atypical symptoms. Immediate ECG and troponin testing guide urgent reperfusion decisions.

The approach to elevated blood pressure using lifestyle modification and pharmacologic therapy selected by comorbidity, with monitoring for control and adverse effects. It aims to reduce cardiovascular and renal events.

Coordinated care of hyperglycemia through nutrition, activity, medication, self-monitoring, and screening for complications, with individualized glycemic targets. It also addresses cardiovascular and renal risk.

A degenerative joint disease characterized by cartilage loss, pain with use, stiffness, and reduced function. Management emphasizes exercise, weight control, analgesia, and joint replacement in advanced cases.

A classification of ligament or muscle-tendon injury from mild stretching to complete rupture, guiding activity restriction, bracing, and rehabilitation. Grading reflects severity of tissue disruption and instability.

An early injury strategy of rest, ice, compression, and elevation to limit swelling and pain after soft tissue trauma. It is combined with progressive rehabilitation rather than prolonged immobilization.

A standardized way of communicating a fracture's location, pattern, displacement, angulation, and joint involvement, often using radiographs. Precise description guides reduction and orthopedic referral.

Measures such as appropriate perioperative antibiotic timing, skin antisepsis, glucose control, and normothermia that reduce infection after surgery. Surveillance and prompt treatment limit morbidity.

A classification of wound closure: primary when edges are approximated, secondary when a wound heals by granulation, and tertiary when closure is deliberately delayed. It predicts scarring and care needs.

Reversible blockade of nerve conduction in a defined region using agents such as lidocaine, often with epinephrine to prolong effect and reduce bleeding. Maximum weight-based doses must be respected.

A systematic, data-driven method such as the Plan-Do-Study-Act cycle for testing changes that improve care processes and outcomes. It differs from research by aiming at local performance rather than generalizable knowledge.