Iraqi Board Family Medicine key terms

A consulting approach that explores the patient's agenda, illness experience, and preferences alongside the clinician's biomedical agenda, then negotiates a shared management plan. It is a core principle of family medicine and underpins continuity of care.

The sustained relationship between a patient and a clinician or team over time, spanning informational, management, and relational dimensions. It enables accumulated knowledge, trust, and coordination, and is a defining feature of general practice.

A system in which primary care clinicians authorise access to specialist, diagnostic, or hospital services. It aims to control costs and improve coordination, but requires strong primary care capacity to avoid delaying necessary care.

A framework holding that health and illness arise from interacting biological, psychological, and social factors. It guides comprehensive assessment in family practice, where presenting problems are often multifactorial and shaped by family and community context.

The coexistence of two or more chronic conditions in one person. It is common in family practice and complicates guideline application, drug interactions, and treatment burden, requiring prioritisation and individualised rather than single-disease care.

The concurrent use of multiple medicines, often defined as five or more regular drugs. It raises risks of interactions and adverse events and warrants structured medication review, especially in older adults with multimorbidity.

The planned, supervised withdrawal or dose reduction of medicines that no longer provide benefit or whose harms outweigh benefits. It is a shared decision with the patient, guided by goals of care, life expectancy, and current evidence.

The outcomes a patient values most, agreed with the clinical team and used to guide treatment intensity. In serious illness they shift discussion from disease targets toward comfort, function, and what matters to the person.

An ongoing process of discussion in which a person records their values, treatment preferences, and chosen decision-maker for future incapacity. It informs clinicians and family and should be reviewed as health and circumstances change.

A patient's voluntary authorisation of an intervention after receiving adequate information about its nature, purpose, risks, benefits, and alternatives, and demonstrating capacity to decide. It is an ethical and legal requirement before most procedures.

A person's ability, at the time of a specific decision, to understand relevant information, retain it, weigh it in reasoning, and communicate a choice. Capacity is decision-specific and presumed unless evidence suggests otherwise.

The duty to protect information disclosed within the clinical relationship and share it only with consent or lawful justification. Its limits include risk of serious harm to others, statutory notification, and necessary coordination of care.

The proportion of people with the disease who correctly test positive, i.e. true positives divided by all diseased. It describes a test's ability to detect disease and is used when ruling out a condition is the priority.

The proportion of people without the disease who correctly test negative, i.e. true negatives divided by all non-diseased. A highly specific test is useful for confirming a diagnosis because it yields few false positives.

The probability that a person with a positive test result truly has the disease. It depends on sensitivity, specificity, and disease prevalence, so it falls when the condition is rare in the tested population.

The ratio of the probability of a given test result in diseased versus non-diseased people. It converts pre-test odds to post-test odds, allowing a test's value to be applied across populations with different prevalence.

The number of patients who must receive an intervention for one additional person to benefit, calculated as the reciprocal of the absolute risk reduction. It expresses clinical benefit in a way that supports shared decisions.

The arithmetic difference in event rates between control and treatment groups. Unlike relative risk reduction it reflects the actual size of benefit and is the basis for calculating number needed to treat.

A range of values within which the true population estimate is likely to lie, usually at 95% confidence. Its width reflects precision, and intervals crossing the null value indicate a statistically non-significant result.

The probability of observing a result as extreme as, or more extreme than, that found if the null hypothesis were true. It is not the probability that the null hypothesis is correct, nor a measure of effect size.

A systematic error that distorts study results away from the true value, unlike random error which affects precision. Common types include selection, information, and confounding, and bias cannot be fixed by enlarging the sample.

Distortion of an exposure-outcome association by a third variable linked to both, creating a spurious or masked effect. It is addressed through study design, restriction, matching, stratification, or multivariable regression.

Allocation of participants to groups by chance, giving each an equal probability of assignment. It balances known and unknown confounders between arms and is the defining strength of the randomised controlled trial.

Analysing participants according to the group to which they were randomised, regardless of adherence. It preserves the benefits of randomisation and gives a pragmatic estimate of effectiveness, though it may dilute treatment effect.

A hierarchy ranking study designs by susceptibility to bias, from systematic reviews of randomised trials at the top through cohort and case-control studies to expert opinion. It guides appraisal but must be matched to the clinical question type.

A structured, protocol-driven synthesis that identifies, appraises, and combines all relevant studies on a focused question. When statistically pooled, it becomes a meta-analysis and provides the most precise estimate of effect.

The tendency for studies with positive or statistically significant findings to be published more readily than negative ones. It inflates pooled effect estimates and is assessed using funnel plots and tests of asymmetry.

The systematic testing of apparently healthy people to detect unrecognised disease early, aiming to improve outcomes. It requires a suitable condition, an acceptable accurate test, effective early treatment, and adequate resources.

Apparent improvement in survival after screening that results only from earlier diagnosis, not from delayed death. It is avoided by measuring disease-specific mortality rather than survival time from diagnosis.

Overestimation of screening benefit because slow-growing, less aggressive tumours remain detectable for longer and are preferentially picked up. It makes screened cases appear to survive longer regardless of any true effect.

Rapid sorting of patients by urgency so that limited resources are directed to those most likely to benefit. It uses physiological and presenting criteria and is reassessed as conditions evolve.

A structured sequence for assessing and treating critically ill patients: Airway, Breathing, Circulation, Disability, and Exposure. Each problem is corrected before moving on, and reassessment is repeated after any deterioration.

A clinical feature suggesting serious underlying pathology and prompting urgent investigation or referral rather than routine management. Examples include weight loss, night pain, neurological deficit, or bleeding in unexplained presentations.

Advice and arrangements given at the end of a consultation about what to do if symptoms persist, worsen, or new features appear, including when and how to seek review. It manages diagnostic uncertainty in primary care.

Guidance to temporarily withhold certain medicines, such as ACE inhibitors, diuretics, metformin, and NSAIDs, during acute dehydrating illness. They reduce the risk of acute kidney injury and are explained to at-risk patients in advance.

A skill or behaviour most children achieve by a given age in domains such as gross motor, fine motor, language, and social interaction. Persistent delay in one or more domains warrants structured assessment and referral.

A plotted reference of weight, length or height, and head circumference against age, used to track a child's growth trajectory. Crossing centile lines downward suggests faltering growth and requires dietary and medical review.

Inadequate physical growth in infancy or childhood, shown by weight or length falling across centile lines or persistently below expected values. Causes include inadequate intake, malabsorption, and underlying disease.

The nationally recommended timing and sequence of vaccines given from infancy onward. Clinicians must know contraindications, catch-up rules, and cold-chain requirements, and should address vaccine hesitancy with evidence-based discussion.

A pregnancy disorder of new hypertension after 20 weeks with proteinuria or maternal organ dysfunction. It threatens mother and fetus and is managed with close monitoring, antihypertensives, and timely delivery.

Glucose intolerance first recognised during pregnancy, arising from pregnancy-related insulin resistance. It increases risks of macrosomia, preeclampsia, and later type 2 diabetes, and is managed with diet, monitoring, and sometimes insulin.

Scheduled health contact during pregnancy covering risk assessment, screening tests, blood pressure and growth monitoring, supplementation, and preparation for birth and parenthood. It aims to detect complications early and promote maternal wellbeing.

Excessive bleeding after childbirth, conventionally over 500 mL after vaginal birth or 1000 mL after caesarean, or any bleeding causing haemodynamic compromise. Uterine atony is the commonest cause and initial management includes uterine massage and uterotonics.

Use of a validated questionnaire such as the PHQ-9 plus clinical interview to identify probable depressive disorder. A positive screen requires diagnostic assessment, not automatic treatment, and should include suicide risk enquiry.

A collaborative, person-centred counselling style that elicits and strengthens a patient's own reasons for change. It uses open questions, affirmation, reflection, and summarising, and is effective for smoking, alcohol, and adherence.

A model describing readiness to alter behaviour through precontemplation, contemplation, preparation, action, and maintenance, with possible relapse. Interventions are matched to stage, since advice alone is ineffective in precontemplation.

Stabilising a suspected or confirmed fracture with a splint, cast, or sling to reduce pain, prevent displacement, and protect soft tissues until definitive care. Neurovascular status is checked before and after application.

A clinical decision tool indicating ankle radiography only if there is pain in the malleolar zone plus bone tenderness at specified sites or inability to bear weight. It safely reduces unnecessary imaging.

A structured communication to another clinician stating the reason for referral, relevant history, findings, investigations, treatment tried, and the specific question asked. Clear letters improve continuity and reduce duplicated work.

Disclosure of patient information without consent or lawful justification, which may be inadvertent, as in public waiting areas or shared screens. It breaches professional duty and can deter patients from seeking care.