ESSENTIALS OF PHARMACOLOGY FOR HEALTH OCCUPATIONS:RX BOOK+CD PHYSIOLOGY,PHARMACY, US $460 – Picture 0

ESSENTIALS OF PHARMACOLOGY FOR HEALTH OCCUPATIONS:RX BOOK+CD PHYSIOLOGY,PHARMACY, US $460 – Picture 1

ESSENTIALS OF PHARMACOLOGY FOR HEALTH OCCUPATIONS:RX BOOK+CD PHYSIOLOGY,PHARMACY, US $460 – Picture 2

Essentials Of Pharmacology For Health Occupations:rx Book+cd Physiology,pharmacy

US $460

Canton, Massachusetts, United States
Jan 30th

Open on mobile:
QR code

PLEASE NOTE: So-so condition, some homework pages ripped out, filled in, but includes the CD ROM. ESSENTIALS OF PHARMACOLOGY FOR HEALTH OCCUPATIONS:RX BOOK+CD PHYSIOLOGY,PHARMACY About this item Product Description Basic and practical, this essential book provides an extensive framework of drug information in a concise format for allied health learners. Learn calculations quickly through a simplified step-by-step process. Discover key drug information by classifications, such as their purpose, side effects, cautions, and interactions, or utilize the resource to refresh your knowledge of drugs. Plug in the free accompanying CD-ROM and master pharmacology through quizzes, games, and case studies. Open this resource now and see how easy learning pharmacology can be!!! REVIEW: The book really breaks down terms and concepts in a way that is easy to understand without the unnecessary clutter that some textbooks add for bulk. I was able take terms I heard and apply them to real world situations as well as understand the tv shows I watch already. Not only does it help for the certification I am going for, but I am more aware going to the doctor now. I will keep this book for future use instead of selling it!!! TABLE OF CONTENTS: Preface Part I: Introduction Chapter 1: Consumer Safety and Drug Regulations Chapter 2: Drug Names and References Chapter 3: Sources and Bodily Effects on Drugs Chapter 4: Medication Preparations and Supplies Chapter 5: Abbreviations and Systems of Measurements Chapter 6: Safe Dosage Preparation. Chapter 7: Responsibilities and Principles of Drug Administration Chapter 8: Administration by the Gastrointestinal Route Chapter 9: Administration by the Parenteral Route Chapter 10: Poison Control Part II: Drug Classifications Chapter 11: Vitamins and Minerals Chapter 12: Skin Medications Chapter 13: Autonomic Nervous System Drugs Chapter 14: Antineoplastic Drugs Chapter 15: Urinary System Drugs Chapter 16: Gastrointestinal Drugs Chapter 17: Anti-Infective Drugs Chapter 18: Eye Medications Chapter 19: Analgesics, Sedatives and Hypnotics Chapter 20: Psychotropic Medications, Alcohol, and Drug Abuse Chapter 21: Musculoskeletal and Anti-Inflammatory Drugs Chapter 22: Anticonvulsants, Antiparkinsonian Drugs, and Agents for Alzheimer's Disease. Chapter 23: Endocrine System Drugs Chapter 24: Reproductive System Drugs Chapter 25: Cardiovascular Drugs Chapter 26: Respiratory System Drugs and Antihistamines Chapter 27: Preoperative Medications and Local Anesthetics Chapter 28: Drugs and Geriatrics Summary Comprehensive Review for Part I Comprehensive Review for Part II Glossary Appendix Index Back About this item Product Details Publisher: Cengage LearningPublication date: July 26, 2006Language: EnglishProduct Dimensions: 0.8 x 8.4 x 10.6 inchesShipping Weight: 2.4 poundsBook length: 640ISBN-10: 1401889255ISBN-13: 978-1401889258 About the Author Ruth Woodrow is a Medical Consultant for Education and Infection Control in the Health Services Department at Senior Friendship Centers, Inc. in Sarasota, Florida. The former Director of Staff Development at Plymouth Harbor, Inc., she also taught pharmacology at the Sarasota County Technical Institute. Essentials of Pharmacology for Health Occupations by Ruth Woodrow (2006, Paperback, Revised)Additional Information about Essentials of Pharmacology for Health Occupations by Ruth Woodrow (2006, Paperback, Revised) Certain data records © 2014 Bowker. Rights in cover images reserved by owners. SynopsisBasic and practical, this essential book provides an extensive framework of drug information in a concise format for allied health learners. Learn calculations quickly through a simplified step-by-step process. Discover key drug information by classifications, such as their purpose, side effects, cautions, and interactions, or utilize the resource to refresh your knowledge of drugs. Plug in the free accompanying CD-ROM and master pharmacology through quizzes, games, and case studies. Open this resource now and see how easy learning pharmacology can be. Organized according to classifications, this book provides an extensive framework of drug information in a concise format. The Internet as a reference tool is examined, and includes links to reliable websites. The new edition is updated with 200 new drugs, information about the uses and effects of herbs, and the USP Quality Review list of similar drug names. CD-ROM in the back of Essentials of Pharmacology for Health Occupations includes: multiple-choice and fill-in the blank questions, a speed test, tic-tac-toe, the Pharmacology Championship Game, Crossword Puzzles, Case Studies and sound-alike drugs activity. Product IdentifiersISBN-101401889255ISBN-139781401889258 Key DetailsAuthorRuth WoodrowNumber Of Pages640 pagesEdition DescriptionRevisedFormatPaperbackPublication Date2006-07-26LanguageEnglishPublisherDelmar Cengage Learning Additional DetailsEdition Number5Copyright Date2007IllustratedYes DimensionsWeight40.9 OzHeight1 In.Width8.5 In.Length11 In. Target AudienceGroupCollege Audience Classification MethodLCCN2006-001536LC Classification NumberRM300.W67 2007Dewey Decimal615.1Dewey Edition22 Table Of ContentTable Of ContentList of Tables. Preface. How to Use the Student Activity CD-ROM. Part I: Introduction. Chapter 1: Consumer Safety and Drug Regulations. Chapter 2: Drug Names and References. Chapter 3: Sources and Bodily Effects of Drugs. Chapter 4: Medication Preparations and Supplies. Chapter 5: Abbreviations and Systems of Measurement. Chapter 6: Safe Dosage Preparation. Chapter 7: Responsibilities and Principles of Drug Administration. Chapter 8: Administration by the Gastrointestinal Route. Chapter 9: Administration by the Parenteral Route. Chapter 10: Poison Control. Part II: Drug Classifications. Chapter 11: Vitamins, Minerals, and Herbs. Chapter 12: Skin Medications. Chapter 13: Autonomic Nervous System Drugs. Chapter 14: Antineoplastic Drugs. Chapter 15: Urinary System Drugs. Chapter 16: Gastrointestinal Drugs. Chapter 17: Anti-Infective Drugs. Chapter 18: Eye Medications. Chapter 19: Analgesics, Sedatives and Hypnotics. Chapter 20: Psychotropic Medications, Alcohol, and Drug Abuse. Chapter 21: Musculoskeletal and Anti-Inflammatory Drugs. Chapter 22: Anticonvulsants, Antiparkinsonian Drugs, and Agents for Alzheimer's Disease. Chapter 23: Endocrine System Drugs. Chapter 24: Reproductive System Drugs. Chapter 25: Cardiovascular Drugs. Chapter 26: Respiratory System Drugs and Antihistamines. Chapter 27: Drugs and Geriatrics. Summary. Appendix: Use Caution ? Avoid Confusion SOME GENERAL INFO ABOUT Pharmacology From Wikipedia, the free encyclopedia A variety of topics involved with pharmacology, including neuropharmacology, renal pharmacology, human metabolism, intracellular metabolism, and intracellular regulation Pharmacology (from Greek ????????, pharmakon, "poison" in classic Greek; "drug" in modern Greek; and -?????, -logia "study of", "knowledge of") is the branch of medicine and biology concerned with the study of drug action,[1] where a drug can be broadly defined as any man-made, natural, or endogenous (within the body) molecule which exerts a biochemical and/or physiological effect on the cell, tissue, organ, or organism. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function. If substances have medicinal properties, they are considered pharmaceuticals. The field encompasses drug composition and properties, synthesis and drug design, molecular and cellular mechanisms, organ/systems mechanisms, signal transduction/cellular communication, molecular diagnostics, interactions, toxicology, chemical biology, therapy, and medical applications and antipathogenic capabilities. The two main areas of pharmacology are pharmacodynamics and pharmacokinetics. The former studies the effects of the drug on biological systems, and the latter the effects of biological systems on the drug. In broad terms, pharmacodynamics discusses the chemicals with biological receptors, and pharmacokinetics discusses the absorption, distribution, metabolism, and excretion (ADME) of chemicals from the biological systems. Pharmacology is not synonymous with pharmacy and the two terms are frequently confused. Pharmacology, a biomedical science, deals with the research, discovery, and characterization of chemicals which show biological effects and the elucidation of cellular and organismal function in relation to these chemicals. In contrast, pharmacy, a health services profession, is concerned with application of the principles learned from pharmacology in its clinical settings; whether it be in a dispensing or clinical care role. In either field, the primary contrast between the two are their distinctions between direct-patient care, for pharmacy practice, and the science-oriented research field, driven by pharmacology. The origins of clinical pharmacology date back to the Middle Ages in Avicenna's The Canon of Medicine, Peter of Spain's Commentary on Isaac, and John of St Amand's Commentary on the Antedotary of Nicholas.[2] Clinical pharmacology owes much of its foundation to the work of William Withering.[3] Pharmacology as a scientific discipline did not further advance until the mid-19th century amid the great biomedical resurgence of that period.[4] Before the second half of the nineteenth century, the remarkable potency and specificity of the actions of drugs such as morphine, quinine and digitalis were explained vaguely and with reference to extraordinary chemical powers and affinities to certain organs or tissues.[5] The first pharmacology department was set up by Rudolf Buchheim in 1847, in recognition of the need to understand how therapeutic drugs and poisons produced their effects.[4] Early pharmacologists focused on natural substances, mainly plant extracts. Pharmacology developed in the 19th century as a biomedical science that applied the principles of scientific experimentation to therapeutic contexts.[6] Today Pharmacologists harness the power of genetics, molecular biology, chemistry, and other advanced tools to transform information about molecular mechanisms and targets into therapies directed against disease, defects or pathogens, and create methods for preventative care, diagnostics, and ultimately personalized medicine. Contents [hide] 1 Divisions 1.1 Clinical pharmacology 1.2 Neuropharmacology 1.3 Psychopharmacology 1.4 Pharmacogenetics 1.5 Pharmacogenomics 1.6 Pharmacoepidemiology 1.7 Toxicology 1.8 Theoretical pharmacology 1.9 Posology 1.10 Pharmacognosy 1.11 Behavioral pharmacology 1.12 Environmental pharmacology 2 Scientific background 3 Medicine development and safety testing 4 Drug legislation and safety 5 Education 6 See also 7 Notes and references 8 External links Divisions[edit] The discipline of pharmacology can be divided into many sub disciplines each with a specific focus. Clinical pharmacology[edit] Clinical pharmacology is the basic science of pharmacology with an added focus on the application of pharmacological principles and methods in the medical clinic and towards patient care and outcomes. Neuropharmacology[edit] Neuropharmacology is the study of the effects of medication on central and peripheral nervous system functioning. Psychopharmacology[edit] Psychopharmacology is the study of the effects of medication on the psyche, observing changed behaviors of the body and mind, and how molecular events are manifest in a measurable behavioral form. Pharmacogenetics[edit] Pharmacogenetics is clinical testing of genetic variation that gives rise to differing response to drugs. Pharmacogenomics[edit] Pharmacogenomics is the application of genomic technologies to drug discovery and further characterization of older drugs. Identification of the genetic basis for polymorphic expression of a gene is done through intronic or exomic single-nucleotide polymorphisms (SNPs) which abolishes the need for different mechanisms for explaining the variability in drug metabolism. SNPs based variations in membrane receptors lead to multidrug resistance (MDR) and the drug–drug interactions. Even drug induced toxicity and many adverse effects can be explained by GWA studies. The multitude of SNPs help in understanding gene pharmacokinetic (PK) or pharmacodynamic (PD) pathways.[7] Pharmacoepidemiology[edit] Pharmacoepidemiology is the study of the effects of drugs in large numbers of people. Toxicology[edit] Toxicology is the study of the adverse effects, molecular targets, and characterization of drugs or any chemical substance in excess (including those beneficial in lower doses). Theoretical pharmacology[edit] Theoretical pharmacology is the study of metrics in pharmacology. Posology[edit] Posology is the study of how medicines are dosed. It also depends upon various factors including age, climate, weight, and sex. Pharmacognosy[edit] Pharmacognosy is a branch of pharmacology dealing especially with the composition, use, and development of medicinal substances of biological origin and especially medicinal substances obtained from plants. Behavioral pharmacology[edit] Behavioral pharmacology, also referred to as psychopharmacology, is an interdisciplinary field which studies behavioral effects of psychoactivedrugs. It incorporates approaches and techniques from neuropharmacology, animal behavior and behavioral neuroscience, and is interested in the behavioral and neurobiological mechanisms of action of psychoactive drugs. Another goal of behavioral pharmacology is to develop animal behavioral models to screen chemical compounds with therapeutic potentials. People in this field (called behavioral pharmacologists) typically use small animals (e.g. rodents) to study psychotherapeutic drugs such as antipsychotics, antidepressants and anxiolytics, and drugs of abuse such as nicotine, cocaine, methamphetamine, etc. Environmental pharmacology[edit] Environmental pharmacology is a new discipline.[8] Focus is being given to understand gene–environment interaction, drug-environment interaction and toxin-environment interaction. There is a close collaboration between environmental science and medicine in addressing these issues, as healthcare itself can be a cause of environmental damage or remediation. Human health and ecology are intimately related. Demand for more pharmaceutical products may place the public at risk through the destruction of species. The entry of chemicals and drugs into the aquatic ecosystem is a more serious concern today. In addition, the production of some illegal drugs pollutes drinking water supply by releasing carcinogens.[9] This field is intimately linked with Public Health fields. Scientific background[edit] The study of chemicals requires intimate knowledge of the biological system affected. With the knowledge of cell biology and biochemistry increasing, the field of pharmacology has also changed substantially. It has become possible, through molecular analysis of receptors, to design chemicals that act on specific cellular signaling or metabolic pathways by affecting sites directly on cell-surface receptors (which modulate and mediate cellular signaling pathways controlling cellular function). A chemical has, from the pharmacological point-of-view, various properties. Pharmacokinetics describes the effect of the body on the chemical (e.g. half-life and volume of distribution), and pharmacodynamics describes the chemical's effect on the body (desired or toxic). When describing the pharmacokinetic properties of the chemical that is the active ingredient or active pharmaceutical ingredient (API), pharmacologists are often interested in L-ADME: Liberation – How is the API disintegrated (for solid oral forms (breaking down into smaller particles)), dispersed, or dissolved from the medication? Absorption – How is the API absorbed (through the skin, the intestine, the oral mucosa)? Distribution – How does the API spread through the organism? Metabolism – Is the API converted chemically inside the body, and into which substances. Are these active (as well)? Could they be toxic? Excretion – How is the API excreted (through the bile, urine, breath, skin)? Medication is said to have a narrow or wide therapeutic index or therapeutic window. This describes the ratio of desired effect to toxic effect. A compound with a narrow therapeutic index (close to one) exerts its desired effect at a dose close to its toxic dose. A compound with a wide therapeutic index (greater than five) exerts its desired effect at a dose substantially below its toxic dose. Those with a narrow margin are more difficult to dose and administer, and may require therapeutic drug monitoring (examples are warfarin, some antiepileptics, aminoglycoside antibiotics). Most anti-cancer drugs have a narrow therapeutic margin: toxic side-effects are almost always encountered at doses used to kill tumors. Medicine development and safety testing[edit] Development of medication is a vital concern to medicine, but also has strong economical and political implications. To protect the consumer and prevent abuse, many governments regulate the manufacture, sale, and administration of medication. In the United States, the main body that regulates pharmaceuticals is the Food and Drug Administration and they enforce standards set by the United States Pharmacopoeia. In the European Union, the main body that regulates pharmaceuticals is the EMEA and they enforce standards set by the European Pharmacopoeia. The metabolic stability and the reactivity of a library of candidate drug compounds have to be assessed for drug metabolism and toxicological studies. Many methods have been proposed for quantitative predictions in drug metabolism; one example of a recent computational method is SPORCalc.[10] If the chemical structure of a medicinal compound is altered slightly, this could slightly or dramatically alter the medicinal properties of the compound depending on the level of alteration as it relates to the structural composition of the substrate or receptor site on which it exerts its medicinal effect, a concept referred to as the structural activity relationship (SAR). This means that when a useful activity has been identified, chemists will make many similar compounds called analogues, in an attempt to maximize the desired medicinal effect(s) of the compound. This development phase can take anywhere from a few years to a decade or more and is very expensive.[11] These new analogues need to be developed. It needs to be determined how safe the medicine is for human consumption, its stability in the human body and the best form for delivery to the desired organ system, like tablet or aerosol. After extensive testing, which can take up to 6 years, the new medicine is ready for marketing and selling.[11] As a result of the long time required to develop analogues and test a new medicine and the fact that of every 5000 potential new medicines typically only one will ever reach the open market, this is an expensive way of doing things, often costing over 1 billion dollars. To recoup this outlay pharmaceutical companies may do a number of things:[11] Carefully research the demand for their potential new product before spending an outlay of company funds.[11] Obtain a patent on the new medicine preventing other companies from producing that medicine for a certain allocation of time.[11] Drug legislation and safety[edit] In the United States, the Food and Drug Administration (FDA) is responsible for creating guidelines for the approval and use of drugs. The FDA requires that all approved drugs fulfill two requirements: The drug must be found to be effective against the disease for which it is seeking approval (where 'effective' means only that the drug performed better than placebo or competitors in at least two trials). The drug must meet safety criteria by being subject to animal and controlled human testing. Gaining FDA approval usually takes several years to attain. Testing done on animals must be extensive and must include several species to help in the evaluation of both the effectiveness and toxicity of the drug. The dosage of any drug approved for use is intended to fall within a range in which the drug produces a therapeutic effect or desired outcome.[12] The safety and effectiveness of prescription drugs in the U.S. is regulated by the federal Prescription Drug Marketing Act of 1987. The Medicines and Healthcare products Regulatory Agency (MHRA) has a similar role in the UK. Education[edit] Students of pharmacology are trained as Biomedical Scientists, studying the effects of drugs on living organisms. This can lead to new drug discoveries, as well as a better understanding of the way in which the human body works. Students of pharmacology must have detailed working knowledge of aspects of physiology, pathology and chemistry. During a typical degree they will cover areas such as (but not limited to) Biochemistry, Biology, Physiology, Genetics, Medical Microbiology and Neuroscience. Whereas a pharmacy student will eventually work in a pharmacy dispensing medications, a pharmacologist will typically work within a laboratory setting. Careers for a pharmacologist include academic positions (medical and non-medical), governmental positions, private industrial positions, science writing, scientific patents and law, consultation, biotech and pharmaceutical employment, the alcohol industry, food industry, forensics/law enforcement, and public health or environmental/ecological sciences. See also[edit] Certain safety factor Cosmeceuticals Crude drugs Nicholas Culpeper – 17th century English Physician who translated and used 'pharmacological texts'. Drug design Drug Discovery Hit to Lead Drug metabolism Enzyme inhibitors Herbalism History of pharmacy International Union of Basic and Clinical Pharmacology Inverse benefit law List of abbreviations used in medical prescriptions List of pharmaceutical companies List of withdrawn drugs Medical School Medicare Part D – the new prescription drug plan in the U.S. Medication Medicinal chemistry Neuropharmacology – The Molecular and Behavior study of Disease and Drugs in the Nervous System Neuropsychopharmacology – The detailed comprehensive study of mind, brain and drugs. Pharmaceutical company Pharmaceutical formulation Pharmaceuticals and personal care products in the environment Pharmacognosy Pharmacopoeia Pharmacotherapy Pharmakeia Pharmakos Placebo (origins of technical term) Prescription drug Prescription Drug Marketing Act (PDMA) Psychopharmacology – medication for mental conditions Traditional Chinese Medicine External links[edit] Wikimedia Commons has media related to Pharmacology. American Society for Pharmacology and Experimental Therapeutics. British Pharmacological Society. Pharmaceutical company profiles at NNDB. International Conference on Harmonisation. US Pharmacopeia. International Union of Basic and Clinical Pharmacology. IUPHAR Committee on Receptor Nomenclature and Drug Classification. [show] v t e Concepts in Pharmacology [show] v t e Pharmacology: major drug groups [show] v t e Branches of chemistry [show] v t e Technology Tabletten.JPGPharmacy and pharmacology portal Categories: Pharmacology Biochemistry ---------------------------- SOME GENERAL INFO ABOUT Pharmacy From Wikipedia, the free encyclopedia Pharmacy PharmacistsMortar.svg Occupation Names Pharmacist, Chemist, Doctor of Pharmacy, Druggist, Apothecary or simply Doctor Occupation type Professional Activity sectors health care, health sciences, chemical sciences Description Competencies The ethics, art and science of medicine, analytical skills, critical thinking Education required Doctor of Pharmacy, Master of Pharmacy Related jobs Doctor, pharmacy technician, toxicologist, chemist, pharmacy assistant other medical specialists The Apothecary or The Chemist by Gabriel Metsu (c. 1651–67) Pharmacy is the science and technique of preparing as well as dispensing drugs and medicines. It is a health profession that links health sciences with chemical sciences and aims to ensure the safe and effective use of pharmaceutical drugs. The scope of pharmacy practice includes more traditional roles such as compounding and dispensing medications, and it also includes more modern services related to health care, including clinical services, reviewing medications for safety and efficacy, and providing drug information. Pharmacists, therefore, are the experts on drug therapy and are the primary health professionals who optimize use of medication for the benefit of the patients. An establishment in which pharmacy (in the first sense) is practiced is called a pharmacy, chemist's or drugstore. In the United States and Canada, drug stores commonly sell not only medicines, but also miscellaneous items such as candy, cosmetics, office supplies, and magazines, as well as refreshments and groceries. The word pharmacy is derived from its root word pharma which was a term used since the 15th–17th centuries. However, the original Greek roots from pharmakos imply sorcery or even poison. In addition to pharma responsibilities, the pharma offered general medical advice and a range of services that are now performed solely by other specialist practitioners, such as surgery and midwifery. The pharma (as it was referred to) often operated through a retail shop which, in addition to ingredients for medicines, sold tobacco and patent medicines. The pharmas also used many other herbs not listed. The Greek word pharmakeia (Greek: ?????????) derives from pharmakon (????????), meaning "drug", "medicine" (or "poison").[1][n 1] In its investigation of herbal and chemical ingredients, the work of the pharma may be regarded as a precursor of the modern sciences of chemistry and pharmacology, prior to the formulation of the scientific method. Contents [hide] 1 Disciplines 2 Professionals 2.1 Pharmacists 2.2 Pharmacy technicians 3 History 4 Types of pharmacy practice areas 4.1 Community pharmacy 4.2 Hospital pharmacy 4.3 Clinical pharmacy 4.4 Ambulatory care pharmacy 4.5 Compounding pharmacy 4.6 Consultant pharmacy 4.7 Internet pharmacy 4.8 Veterinary pharmacy 4.9 Nuclear pharmacy 4.10 Military pharmacy 4.11 Pharmacy informatics 5 Issues in pharmacy 5.1 Separation of prescribing from dispensing 5.2 The future of pharmacy 6 Pharmacy journals 7 See also 8 Symbols 9 Notes and references 10 References 11 External links Disciplines[edit] Pharmacy, tacuinum sanitatis casanatensis (14th century) The field of pharmacy can generally be divided into three primary disciplines: Pharmaceutics Medicinal Chemistry and Pharmacognosy Pharmacy Practice The boundaries between these disciplines and with other sciences, such as biochemistry, are not always clear-cut. Often, collaborative teams from various disciplines (pharmacists and other scientists) work together toward the introduction of new therapeutics and methods for patient care. However, pharmacy is not a basic or biomedical science in its typical form. Medicinal Chemistry,on its own, is also a distinct branch of science of synthetic chemistry combining pharmacology, organic chemistry, and chemical biology. Pharmacology is sometimes considered as the 4th discipline of pharmacy. Although pharmacology is essential to the study of pharmacy, it is not specific to pharmacy. Both disciplines are distinct.Those who wish to practice both pharmacy (patient oriented) and pharmacology (a biomedical science requiring the scientific method) receive separate training and degrees unique to either discipline. Pharmacoinformatics is considered another new discipline, for systematic drug discovery and development with efficiency and safety. Professionals[edit] The World Health Organization estimates that there are at least 2.6 million pharmacists and other pharmaceutical personnel worldwide.[3] Pharmacists[edit] Main article: Pharmacist Pharmacists are healthcare professionals with specialised education and training who perform various roles to ensure optimal health outcomes for their patients through proper medication use. Pharmacists may also be small-business proprietors, owning the pharmacy in which they practice. Since pharmacists know about the chemical synthesis mode of action of a particular drug, and its metabolism and physiological effects on the human body in great detail, they play an important role in optimisation of a drug treatment for an individual. Pharmacists are represented internationally by the International Pharmaceutical Federation (FIP). They are represented at the national level by professional organisations such as the Royal Pharmaceutical Society in the UK, the Pharmacy Guild of Australia (PGA), the Canadian Pharmacists Association (CPhA), and the American Pharmacists Association (APhA), See also: List of pharmacy associations. In some cases, the representative body is also the registering body, which is responsible for the regulation and ethics of the profession. In the United States, specializations in pharmacy practice recognized by the Board of Pharmaceutical Specialties include: cardiovascular, infectious disease, oncology, pharmacotherapy, nuclear, nutrition, and psychiatry.[4] The Commission for Certification in Geriatric Pharmacy certifies pharmacists in geriatric pharmacy practice. The American Board of Applied Toxicology certifies pharmacists and other medical professionals in applied toxicology. Pharmacy technicians[edit] Main article: Pharmacy technician Pharmacy technicians support the work of pharmacists and other health professionals by performing a variety of pharmacy related functions, including dispensing prescription drugs and other medical devices to patients and instructing on their use. They may also perform administrative duties in pharmaceutical practice, such as reviewing prescription requests with doctor's offices and insurance companies to ensure correct medications are provided and payment is received. A Pharmacy Technician in the UK is considered a health care professional and often does not work under the direct supervision of a pharmacist (if employed in a hospital pharmacy) but instead is supervised and managed by other senior pharmacy technicians. In the UK the role of a PhT has grown and responsibility has been passed on to them to manage the pharmacy department and specialised areas in pharmacy practice allowing pharmacists the time to specialise in their expert field as medication consultants spending more time working with patients and in research. A pharmacy technician once qualified has to register as a professional on the General Pharmaceutical Council (GPhC) register. The GPhC is the governing body for pharmacy health care professionals and this is who regulates the practice of pharmacists and pharmacy technicians. In the US, pharmacy technicians perform their duties under supervision of pharmacists. Although they may perform, under supervision, most dispensing, compounding and other tasks, they are not generally allowed to perform the role of counseling patients on the proper use of their medications. History[edit] Main articles: History of pharmacy and List of pharmacists Doctor and pharmacist, illustration from Medicinarius (1505) by Hieronymus Brunschwig. The earliest known compilation of medicinal substances was the Sushruta Samhita, an Indian Ayurvedic treatise attributed to Sushruta in the 6th century BC. However, the earliest text as preserved dates to the 3rd or 4th century AD. Many Sumerian (late 6th millennium BC - early 2nd millennium BC) cuneiform clay tablets record prescriptions for medicine.[5] Ancient Egyptian pharmacological knowledge was recorded in various papyri such as the Ebers Papyrus of 1550 BC, and the Edwin Smith Papyrus of the 16th century BC. Dioscorides, De Materia Medica, Byzantium, 15th century In Ancient Greece, Diocles of Carystus (4th century BC) was one of several men studying the medicinal properties of plants. He wrote several treatises on the topic.[6] The Greek physician Pedanius Dioscorides is famous for writing a five volume book in his native Greek ???? ???? ???????? in the 1st century AD. The Latin translation De Materia Medica (Concerning medical substances) was used a basis for many medieval texts, and was built upon by many middle eastern scientists during the Islamic Golden Age. The title coined the term materia medica. The earliest known Chinese manual on materia medica is the Shennong Bencao Jing (The Divine Farmer's Herb-Root Classic), dating back to the 1st century AD. It was compiled during the Han dynasty and was attributed to the mythical Shennong. Earlier literature included lists of prescriptions for specific ailments, exemplified by a manuscript "Recipes for 52 Ailments", found in the Mawangdui tomb, sealed in 168 BC. Further details on Chinese pharmacy can be found in the Pharmacy in China article. In Japan, at the end of the Asuka period (538-710) and the early Nara period (710-794), the men who fulfilled roles similar to those of modern pharmacists were highly respected. The place of pharmacists in society was expressly defined in the Taiho Code (701) and re-stated in the Yoro Code (718). Ranked positions in the pre-Heian Imperial court were established; and this organizational structure remained largely intact until the Meiji Restoration (1868). In this highly stable hierarchy, the pharmacists—and even pharmacist assistants—were assigned status superior to all others in health-related fields such as physicians and acupuncturists. In the Imperial household, the pharmacist was even ranked above the two personal physicians of the Emperor.[7] There is a stone sign for a pharmacy with a tripod, a mortar, and a pestle opposite one for a doctor in the Arcadian Way in Ephesus near Kusadasi in Turkey.[8] The current Ephesus dates back to 400BC and was the site of the Temple of Artemis one of the seven wonders of the world, the home of Mark Anthony and Cleopatra, Mary Magdalen and where St Paul read his letter to the Ephesians. In Baghdad the first pharmacies, or drug stores, were established in 754,[9] under the Abbasid Caliphate during the Islamic Golden Age. By the 9th century, these pharmacies were state-regulated.[10][unreliable source?] The advances made in the Middle East in botany and chemistry led medicine in medieval Islam substantially to develop pharmacology. Muhammad ibn Zakariya Razi (Rhazes) (865-915), for instance, acted to promote the medical uses of chemical compounds. Abu al-Qasim al-Zahrawi (Abulcasis) (936-1013) pioneered the preparation of medicines by sublimation and distillation. His Liber servitoris is of particular interest, as it provides the reader with recipes and explains how to prepare the `simples’ from which were compounded the complex drugs then generally used. Sabur Ibn Sahl (d 869), was, however, the first physician to initiate pharmacopoedia, describing a large variety of drugs and remedies for ailments. Al-Biruni (973-1050) wrote one of the most valuable Islamic works on pharmacology entitled Kitab al-Saydalah (The Book of Drugs), where he gave detailed knowledge of the properties of drugs and outlined the role of pharmacy and the functions and duties of the pharmacist. Avicenna, too, described no less than 700 preparations, their properties, mode of action and their indications. He devoted in fact a whole volume to simple drugs in The Canon of Medicine. Of great impact were also the works by al-Maridini of Baghdad and Cairo, and Ibn al-Wafid (1008–1074), both of which were printed in Latin more than fifty times, appearing as De Medicinis universalibus et particularibus by `Mesue' the younger, and the Medicamentis simplicibus by `Abenguefit'. Peter of Abano (1250–1316) translated and added a supplement to the work of al-Maridini under the title De Veneris. Al-Muwaffaq’s contributions in the field are also pioneering. Living in the 10th century, he wrote The foundations of the true properties of Remedies, amongst others describing arsenious oxide, and being acquainted with silicic acid. He made clear distinction between sodium carbonate and potassium carbonate, and drew attention to the poisonous nature of copper compounds, especially copper vitriol, and also lead compounds. He also describes the distillation of sea-water for drinking.[11][verification needed] In Europe pharmacy-like shops began to appear during the 12th century. In 1240 emperor Frederic II issued a decree by which the physician's and the apothecary's professions were separated.[12] The first pharmacy in Europe (still working) was opened in 1241 in Trier, Germany.[citation needed] Sign of the Town Hall Pharmacy in Tallinn, operating continuously from at least 1422 In Europe there are old pharmacies still operating in Dubrovnik, Croatia located inside the Franciscan monastery, opened in 1317 ; and one in the Town Hall Square of Tallinn, Estonia dating from at least 1422. The oldest is claimed to be set up in 1221 in the Church of Santa Maria Novella in Florence, Italy, which now houses a perfume museum. The medieval Esteve Pharmacy, located in Llivia, a Catalan enclave close to Puigcerda, is also now a museum dating back to the 15th century, keeping albarellos from the 16th and 17th centuries, old prescription books and antique drugs. The mortar and pestle, one of the internationally recognized symbols to represent the pharmacy profession Typical American drug store with a soda fountain, about 1905 Drug store restoration ca. 1920 at Collingsworth County Museum and Art Center across from the courthouse in Wellington, Texas Types of pharmacy practice areas[edit] Pharmacists practice in a variety of areas including community pharmacies, hospitals, clinics, extended care facilities, psychiatric hospitals, and regulatory agencies. Pharmacists can specialize in various areas of practice including but not limited to: hematology/oncology, infectious diseases, ambulatory care, nutrition support, drug information, critical care, pediatrics, etc. Community pharmacy[edit] 19th-century Italian pharmacy Classic symbols at the wall of a former German pharmacy Modern pharmacy in Norway See also: Pharmacy automation A pharmacy (commonly the chemist in Australia, New Zealand and the UK; or drugstore in North America; retail pharmacy in industry terminology; or Apothecary, historically) is the place where most pharmacists practice the profession of pharmacy. It is the community pharmacy where the dichotomy of the profession exists—health professionals who are also retailers. Community pharmacies usually consist of a retail storefront with a dispensary where medications are stored and dispensed. According to Sharif Kaf al-Ghazal, the opening of the first drugstores are recorded by Muslim pharmacists in Baghdad in 754.[9][13] In most countries, the dispensary is subject to pharmacy legislation; with requirements for storage conditions, compulsory texts, equipment, etc., specified in legislation. Where it was once the case that pharmacists stayed within the dispensary compounding/dispensing medications, there has been an increasing trend towards the use of trained pharmacy technicians while the pharmacist spends more time communicating with patients. Pharmacy technicians are now more dependent upon automation to assist them in their new role dealing with patients' prescriptions and patient safety issues. Pharmacies are typically required to have a pharmacist on-duty at all times when open. It is also often a requirement that the owner of a pharmacy must be a registered pharmacist, although this is not the case in all jurisdictions, such that many retailers (including supermarkets and mass merchandisers) now include a pharmacy as a department of their store. Likewise, many pharmacies are now rather grocery store-like in their design. In addition to medicines and prescriptions, many now sell a diverse arrangement of additional items such as cosmetics, shampoo, office supplies, confections, snack foods, durable medical equipment, greeting cards, and provide photo processing services. Hospital pharmacy[edit] Main article: Hospital pharmacy Pharmacies within hospitals differ considerably from community pharmacies. Some pharmacists in hospital pharmacies may have more complex clinical medication management issues whereas pharmacists in community pharmacies often have more complex business and customer relations issues. Because of the complexity of medications including specific indications, effectiveness of treatment regimens, safety of medications (i.e., drug interactions) and patient compliance issues (in the hospital and at home) many pharmacists practicing in hospitals gain more education and training after pharmacy school through a pharmacy practice residency and sometimes followed by another residency in a specific area. Those pharmacists are often referred to as clinical pharmacists and they often specialize in various disciplines of pharmacy. For example, there are pharmacists who specialize in hematology/oncology, HIV/AIDS, infectious disease, critical care, emergency medicine, toxicology, nuclear pharmacy, pain management, psychiatry, anti-coagulation clinics, herbal medicine, neurology/epilepsy management, pediatrics, neonatal pharmacists and more. Hospital pharmacies can often be found within the premises of the hospital. Hospital pharmacies usually stock a larger range of medications, including more specialized medications, than would be feasible in the community setting. Most hospital medications are unit-dose, or a single dose of medicine. Hospital pharmacists and trained pharmacy technicians compound sterile products for patients including total parenteral nutrition (TPN), and other medications given intravenously. This is a complex process that requires adequate training of personnel, quality assurance of products, and adequate facilities. Several hospital pharmacies have decided to outsource high risk preparations and some other compounding functions to companies who specialize in compounding. The high cost of medications and drug-related technology, combined with the potential impact of medications and pharmacy services on patient-care outcomes and patient safety, make it imperative that hospital pharmacies perform at the highest level possible. Clinical pharmacy[edit] Main article: Clinical pharmacy Pharmacists provide direct patient care services that optimizes the use of medication and promotes health, wellness, and disease prevention.[14] Clinical pharmacists care for patients in all health care settings, but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists often collaborate with physicians and other healthcare professionals to improve pharmaceutical care. Clinical pharmacists are now an integral part of the interdisciplinary approach to patient care. They often participate in patient care rounds drug product selection. The clinical pharmacist's role involves creating a comprehensive drug therapy plan for patient-specific problems, identifying goals of therapy, and reviewing all prescribed medications prior to dispensing and administration to the patient. The review process often involves an evaluation of the appropriateness of the drug therapy (e.g., drug choice, dose, route, frequency, and duration of therapy) and its efficacy. The pharmacist must also monitor for potential drug interactions, adverse drug reactions, and assess patient drug allergies while designing and initiating a drug therapy plan.[15] Ambulatory care pharmacy[edit] Since the emergence of modern clinical pharmacy, ambulatory care pharmacy practice has emerged as a unique pharmacy practice setting. In 2011 the board of Pharmaceutical Specialties approved ambulatory care pharmacy practice as a separate board certification. The official designation for pharmacists who pass the ambulatory care pharmacy specialty certification exam will be Board Certified Ambulatory Care Pharmacist and these pharmacists will carry the initials BCACP.[16] Ambulatory care pharmacy is based primarily on pharmacotherapy services that a pharmacist provides in a clinic. Pharmacists in this setting often do not dispense drugs, but rather see patients in office visits to manage chronic disease states. In the federal health care system (including the VA, the Indian Health Service, and NIH) ambulatory care pharmacists are given full independent prescribing authority. In some states such North Carolina and New Mexico these pharmacist clinicians are given collaborative prescriptive and diagnostic authority.[17] Compounding pharmacy[edit] Main article: Compounding Compounding is the practice of preparing drugs in new forms. For example, if a drug manufacturer only provides a drug as a tablet, a compounding pharmacist might make a medicated lollipop that contains the drug. Patients who have difficulty swallowing the tablet may prefer to suck the medicated lollipop instead. Another form of compounding is by mixing different strengths (g,mg,mcg) of capsules or tablets to yield the desired amount of medication indicated by the physician, physician assistant, Nurse Practitioner, or clinical pharmacist practitioner. This form of compounding is found at community or hospital pharmacies or in-home administration therapy. Compounding pharmacies specialize in compounding, although many also dispense the same non-compounded drugs that patients can obtain from community pharmacies. Consultant pharmacy[edit] Main article: Consultant pharmacist Consultant pharmacy practice focuses more on medication regimen review (i.e. "cognitive services") than on actual dispensing of drugs. Consultant pharmacists most typically work in nursing homes, but are increasingly branching into other institutions and non-institutional settings.[18] Traditionally consultant pharmacists were usually independent business owners, though in the United States many now work for several large pharmacy management companies (primarily Omnicare, Kindred Healthcare and PharMerica). This trend may be gradually reversing as consultant pharmacists begin to work directly with patients, primarily because many elderly people are now taking numerous medications but continue to live outside of institutional settings. Some community pharmacies employ consultant pharmacists and/or provide consulting services. The main principle of consultant pharmacy is developed by Hepler and Strand in 1990.[19][20] Internet pharmacy[edit] Main article: Online pharmacy Canisters of pills from a mail order pharmacy. Since about the year 2000, a growing number of Internet pharmacies have been established worldwide. Many of these pharmacies are similar to community pharmacies, and in fact, many of them are actually operated by brick-and-mortar community pharmacies that serve consumers online and those that walk in their door. The primary difference is the method by which the medications are requested and received. Some customers consider this to be more convenient and private method rather than traveling to a community drugstore where another customer might overhear about the drugs that they take. Internet pharmacies (also known as online pharmacies) are also recommended to some patients by their physicians if they are homebound. While most Internet pharmacies sell prescription drugs and require a valid prescription, some Internet pharmacies sell prescription drugs without requiring a prescription. Many customers order drugs from such pharmacies to avoid the "inconvenience" of visiting a doctor or to obtain medications which their doctors were unwilling to prescribe. However, this practice has been criticized as potentially dangerous, especially by those who feel that only doctors can reliably assess contraindications, risk/benefit ratios, and an individual's overall suitability for use of a medication. There also have been reports of such pharmacies dispensing substandard products.[citation needed] Of particular concern with Internet pharmacies is the ease with which people, youth in particular, can obtain controlled substances (e.g., Vicodin, generically known as hydrocodone) via the Internet without a prescription issued by a doctor/practitioner who has an established doctor-patient relationship. There are many instances where a practitioner issues a prescription, brokered by an Internet server, for a controlled substance to a "patient" s/he has never met.[citation needed] In the United States, in order for a prescription for a controlled substance to be valid, it must be issued for a legitimate medical purpose by a licensed practitioner acting in the course of legitimate doctor-patient relationship. The filling pharmacy has a corresponding responsibility to ensure that the prescription is valid. Often, individual state laws outline what defines a valid patient-doctor relationship. Canada is home to dozens of licensed Internet pharmacies, many of which sell their lower-cost prescription drugs to U.S. consumers, who pay one of the world's highest drug prices.[21] In recent years, many consumers in the US and in other countries with high drug costs, have turned to licensed Internet pharmacies in India, Israel and the UK, which often have even lower prices than in Canada. In the United States, there has been a push to legalize importation of medications from Canada and other countries, in order to reduce consumer costs. While in most cases importation of prescription medications violates Food and Drug Administration (FDA) regulations and federal laws, enforcement is generally targeted at international drug suppliers, rather than consumers. There is no known case of any U.S. citizens buying Canadian drugs for personal use with a prescription, who has ever been charged by authorities. Veterinary pharmacy[edit] Veterinary pharmacies, sometimes called animal pharmacies, may fall in the category of hospital pharmacy, retail pharmacy or mail-order pharmacy. Veterinary pharmacies stock different varieties and different strengths of medications to fulfill the pharmaceutical needs of animals. Because the needs of animals, as well as the regulations on veterinary medicine, are often very different from those related to people, veterinary pharmacy is often kept separate from regular pharmacies. Nuclear pharmacy[edit] Main article: Nuclear pharmacy Nuclear pharmacy focuses on preparing radioactive materials for diagnostic tests and for treating certain diseases. Nuclear pharmacists undergo additional training specific to handling radioactive materials, and unlike in community and hospital pharmacies, nuclear pharmacists typically do not interact directly with patients. Military pharmacy[edit] Military pharmacy is an entirely different working environment due to the fact that technicians perform most duties that in a civilian sector would be illegal. State laws of Technician patient counseling and medication checking by a pharmacist do not apply.[citation needed] Pharmacy informatics[edit] Main article: Pharmacy informatics Pharmacy informatics is the combination of pharmacy practice science and applied information science. Pharmacy informaticists work in many practice areas of pharmacy, however, they may also work in information technology departments or for healthcare information technology vendor companies. As a practice area and specialist domain, pharmacy informatics is growing quickly to meet the needs of major national and international patient information projects and health system interoperability goals. Pharmacists in this area are trained to participate in medication management system development, deployment and optimization. Issues in pharmacy[edit] Separation of prescribing from dispensing[edit] In most jurisdictions (such as the United States), pharmacists are regulated separately from physicians. These jurisdictions also usually specify that only pharmacists may supply scheduled pharmaceuticals to the public, and that pharmacists cannot form business partnerships with physicians or give them "kickback" payments. However, the American Medical Association (AMA) Code of Ethics provides that physicians may dispense drugs within their office practices as long as there is no patient exploitation and patients have the right to a written prescription that can be filled elsewhere. 7 to 10 percent of American physicians practices reportedly dispense drugs on their own.[22] In some rural areas in the United Kingdom, there are dispensing doctors[23] who are allowed to both prescribe and dispense prescription-only medicines to their patients from within their practices. The law requires that the GP practice be located in a designated rural area and that there is also a specified, minimum distance (currently 1.6 kilometres) between a patient's home and the nearest retail pharmacy. This law also exists in Austria for general physicians if the nearest pharmacy is more than 4 kilometers away, or where none is registered in the city. One of a chain of pharmacies in Mexico City, Mexico, named "Doctor Discount," March 2010. In other jurisdictions (particularly in Asian countries such as China, Malaysia, and Singapore), doctors are allowed to dispense drugs themselves and the practice of pharmacy is sometimes integrated with that of the physician, particularly in traditional Chinese medicine. In Canada it is common for a medical clinic and a pharmacy to be located together and for the ownership in both enterprises to be common, but licensed separately. The reason for the majority rule is the high risk of a conflict of interest and/or the avoidance of absolute powers. Otherwise, the physician has a financial self-interest in "diagnosing" as many conditions as possible, and in exaggerating their seriousness, because he or she can then sell more medications to the patient. Such self-interest directly conflicts with the patient's interest in obtaining cost-effective medication and avoiding the unnecessary use of medication that may have side-effects. This system reflects much similarity to the checks and balances system of the U.S. and many other governments.[citation needed] A campaign for separation has begun in many countries and has already been successful (as in Korea). As many of the remaining nations move towards separation, resistance and lobbying from dispensing doctors who have pecuniary interests may prove a major stumbling block (e.g. in Malaysia).[citation needed] The future of pharmacy[edit] In the coming decades, pharmacists are expected to become more integral within the health care system. Rather than simply dispensing medication, pharmacists are increasingly expected to be compensated for their patient care skills.[24] In particular, Medication Therapy Management (MTM) includes the clinical services that pharmacists can provide for their patients. Such services include the thorough analysis of all medication (prescription, non-prescription, and herbals) currently being taken by an individual. The result is a reconciliation of medication and patient education resulting in increased patient health outcomes and decreased costs to the health care system.[25] This shift has already commenced in some countries; for instance, pharmacists in Australia receive remuneration from the Australian Government for conducting comprehensive Home Medicines Reviews. In Canada, pharmacists in certain provinces have limited prescribing rights (as in Alberta and British Columbia) or are remunerated by their provincial government for expanded services such as medications reviews (Medschecks in Ontario). In the United Kingdom, pharmacists who undertake additional training are obtaining prescribing rights and this is because of pharmacy education. They are also being paid for by the government for medicine use reviews. In Scotland the pharmacist can write prescriptions for Scottish registered patients of their regular medications, for the majority of drugs, except for controlled drugs, when the patient is unable to see their doctor, as could happen if they are away from home or the doctor is unavailable. In the United States, pharmaceutical care or clinical pharmacy has had an evolving influence on the practice of pharmacy.[26] Moreover, the Doctor of Pharmacy (Pharm. D.) degree is now required before entering practice and some pharmacists now complete one or two years of residency or fellowship training following graduation. In addition, consultant pharmacists, who traditionally operated primarily in nursing homes are now expanding into direct consultation with patients, under the banner of "senior care pharmacy."[27] Pharmacy journals[edit] List of Pharmacy Journals See also[edit] American Society for Pharmacy Law Apothecary Bachelor of Pharmacy, Master of Pharmacy, Doctor of Pharmacy Classification of Pharmaco-Therapeutic Referrals Clinical pharmacy Consultant pharmacist Evidence-based pharmacy in developing countries History of pharmacy Hospital pharmacy International Pharmaceutical Federation International Pharmaceutical Students’ Federation List of pharmacies List of pharmacy associations List of pharmacy organizations in the United Kingdom List of pharmacy schools in the United States List of pharmacy schools Nuclear pharmacy Online pharmacy Pharmaceutical company Pharmaceutical industry Pharmacogenetics Pharmacogenomics Pharmacognosy Pharmacology Pharmaconomist Pharmacy Automation - The Tablet Counter Pharmacy residency Pharmacy informatics Professional Further Education in Clinical Pharmacy and Public Health Raeapteek (one of the oldest continuously run pharmacies in Europe) Telepharmacy Symbols[edit] The two symbols most commonly associated with pharmacy are the mortar and pestle and the ? (recipere) character, which is often written as "Rx" in typed text. The show globe was also used in English-speaking countries until the early 20th century. Pharmacy organizations often use other symbols, such as the Bowl of Hygieia which is often used in the Netherlands, conical measures, and caduceuses in their logos. Other symbols are common in different countries: the green Greek cross in France, Argentina, the United Kingdom, Belgium, Ireland, Italy, Spain, and India, the increasingly rare Gaper in the Netherlands, and a red stylized letter A in Germany and Austria (from Apotheke, the German word for pharmacy, from the same Greek root as the English word 'apothecary'). Bowl of Hygieia, the internationally recognised symbol of pharmacy (the profession) Rod of Asclepius, the internationally recognised symbol of medicine Green cross and Bowl of Hygieia used in Europe (with the exception of Germany and Austria) and India Simple green cross, also used in Europe and India Red "A" (Apotheke) sign, used in Germany Similar red "A" sign, used in Austria The mortar and pestle, used in the United States and Canada A hanging show-globe, formerly used in the United States The Gaper, formerly used in the Netherlands The symbol used on medical prescriptions, from the Latin Recipe Notes and references[edit] Notes Jump up ^ Its earliest attested form in Greek could be the Mycenaean ???, pa-ma-ko, written in the Linear B syllabic script and found on the PY Un 1314 tablet; this tablet is also found listed as PY Vn 1314 or PY Sb 1314.[2] External links[edit] Wikimedia Commons has media related to Pharmacy. Look up pharmacy in Wiktionary, the free dictionary. Pharmacy Professionals Guide Guide for Pharmacy students and Teachers Pharmacists Navigator History of Pharmacy Collection of internet resources related to the history of pharmacy Soderlund Pharmacy Museum - Information about the history of the American Drugstore The Lloyd Library Library of botanical, medical, pharmaceutical, and scientific books and periodicals, and works of allied sciences American Institute of the History of Pharmacy American Institute of the History of Pharmacy—resources in the history of pharmacy International Pharmaceutical Federation (FIP) Federation representing national associations of pharmacists and pharmaceutical scientists. Information and resources relating to pharmacy education, practice, science and policy Pharmaboard German association of pharmacy students [show] v t e Allied health professions [show] v t e Branches of chemistry [show] v t e Health care Tabletten.JPGPharmacy and Pharmacology portal Categories: Pharmacy Medicinal chemistry -------------------------- SOME GENERAL INFO ABOUT Medical PROCEDURES From Wikipedia, the free encyclopedia A medical procedure is a course of action intended to achieve a result in the care of persons with health problems. A medical procedure with the intention of determining, measuring or diagnosing a patient condition or parameter is also called a medical test. Other common kinds of procedures are therapeutic (i.e., with the intention or treating, curing or restoring function or structure), including the large group of surgical procedures. Rehabilitation procedures are included in this group. Contents [hide] 1 Definition 2 List of medical procedures 2.1 Propaedeutic 2.2 Diagnostic 2.3 Therapeutic 2.4 Surgical 2.5 Anesthesia 2.6 Other 3 See also 4 References Definition[edit] "An activity directed at or performed on an individual with the object of improving health, treating disease or injury, or making a diagnosis."[1] "The act or conduct of diagnosis, treatment, or operation."[2] "A series of steps by which a desired result is accomplished."[3] "The sequence of steps to be followed in establishing some course of action."[4] List of medical procedures[edit] Propaedeutic[edit] Auscultation Medical inspection (body features) Palpation Percussion (medicine) Vital signs, such body temperature, pulse (or heart rate) and blood pressure. Diagnostic[edit] Lab tests Blood test Urinalysis Stool test Biopsy test Cardiac stress test Electrocardiography Electroencephalography Electrocorticography Electromyography Electroneuronography Electronystagmography Electrooculography Electroretinography Endoluminal capsule monitoring Endoscopy Colonoscopy Colposcopy Cystoscopy Gastroscopy Laparoscopy Laryngoscopy Ophthalmoscopy Otoscopy Sigmoidoscopy Esophageal motility study Evoked potential Magnetoencephalography Medical imaging Angiography Aortography Cerebral angiography Coronary angiography Lymphangiography Pulmonary angiography Ventriculography Chest photofluorography Computed tomography Echocardiography Electrical impedance tomography Fluoroscopy Magnetic resonance imaging Diffuse optical imaging Diffusion-weighted imaging Diffusion tensor imaging Functional magnetic resonance imaging Positron emission tomography Radiography Scintillography SPECT Ultrasonography Gynecologic ultrasonography Obstetric ultrasonography Contrast-enhanced ultrasound Intravascular ultrasound Thermography Virtual colonoscopy Neuroimaging Posturography Therapeutic[edit] See also: Therapy, List of surgical procedures Precordial thump Politzerization Hemodialysis Hemofiltration Plasmapheresis Apheresis Extracorporeal membrane oxygenation (ECMO) Cancer immunotherapy Cancer vaccine Cervical conization Chemotherapy Cytoluminescent therapy Insulin potentiation therapy Low-dose chemotherapy Monoclonal antibody therapy Photodynamic therapy Radiation therapy Targeted therapy Tracheal intubation Unsealed source radiotherapy Virtual reality therapy Physical therapy Speech therapy Phototerapy Hydrotherapy Heat therapy Shock therapy Insulin shock therapy Electroconvulsive therapy Symptomatic treatment Fluid replacement therapy Palliative care Hyperbaric oxygen therapy Oxygen therapy Gene therapy Enzyme replacement therapy Intravenous therapy Kinesiotherapy Phage therapy Respiratory therapy Vision therapy Electrotherapy Transcutaneous electrical nerve stimulation (TENS) Laser therapy Combination therapy Occupational therapy Immunization Vaccination Immunosuppressive therapy Psychotherapy Drug therapy Acupuncture Antivenom Magnetic therapy Craniosacral therapy Chelation therapy Hormonal therapy Hormone replacement therapy Opiate replacement therapy Cell therapy Stem cell treatments Proton therapy Intubation Nebulization Inhalation therapy Ion therapy[disambiguation needed] Fluoride therapy Cold compression therapy Animal-Assisted Therapy Negative Pressure Wound Therapy Nicotine replacement therapy Oral rehydration therapy Surgical[edit] Biopsy Stereotactic surgery Radiosurgery Endoscopic surgery Lithotomy Image-guided surgery Facial rejuvenation Neovaginoplasty Vaginoplasty Ablation Amputation Cardiopulmonary resuscitation (CPR) Cryosurgery General surgery Hand surgery Laminectomy Hemilaminectomy Laparoscopic surgery Lithotriptor Lobotomy Knee cartilage replacement therapy Xenotransplantation Anesthesia[edit] Local anesthesia Topical anesthesia (surface) Epidural (extradural) block Spinal anesthesia (subarachnoid block) Regional anesthesia General anesthesia Dissociative anesthesia Other[edit] Interventional radiology Screening (medicine) See also[edit] Algorithm (medical) Autopsy Complication (medicine) Consensus (medical) Contraindication Course (medicine) Drug interaction Extracorporeal Guideline (medical) Iatrogenesis Invasive (medical) List of surgical instruments Medical error Medical prescription Medical test Minimally invasive Nocebo Non-invasive Physical examination Responsible drug use Surgical instruments Vital signs References[edit] Jump up ^ International Dictionary of Medicine and Biology, Page 2297. ISBN 0-471-01849-X Jump up ^ Stedman's Medical Dictionary, 27th ed. Page 1446. ISBN 0-683-40007-X Jump up ^ Dorland's Illustrated Medical Dictionary, 28th ed. Page 1353. ISBN 0-7216-2859-1 Jump up ^ Mosby's Medical, Nursing, & Allied Health Dictionary, Page 1278. ISBN 0-8016-7225-2 Categories: Medical terminologyMedical treatments ------------- SOME GENERAL INFO ABOUT SOME GENERAL INFO ABOUT Current Procedural Terminology From Wikipedia, the free encyclopedia The Current Procedural Terminology (CPT) code set is a medical code set maintained by the American Medical Association through the CPT Editorial Panel.[1] The CPT code set (copyright protected by the AMA) describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes. New editions are released each October.[2] The current version is the CPT 2014. It is available in both a standard edition and a professional edition.[3][4] CPT coding is similar to ICD-9 and ICD-10 coding, except that it identifies the services rendered rather than the diagnosis on the claim. ICD code sets also contain procedure codes but these are only used in the inpatient setting.[5] CPT is currently identified by the Centers for Medicare and Medicaid Services (CMS)[6] as Level 1 of the Health Care Procedure Coding System. The Current Procedural Terminology (CPT) was developed by the American Medical Association (AMA).[6] Contents [hide] 1 Types of code 1.1 Category I 1.1.1 Codes for evaluation and management: 99201–99499 1.1.2 Codes for anesthesia: 00100–01999; 99100–99150 1.1.3 Codes for surgery: 10021–69990 1.1.4 Codes for Radiology: 70010-79999 1.1.5 Codes for pathology and laboratory: 80047–89398 1.1.6 Codes for medicine: 90281–99099; 99151–99199; 99500–99607 1.2 Category II 1.3 Category III 2 Major psychotherapy revisions 3 Copyright 3.1 Limited CPT search offered by the AMA 4 See also 5 References 6 External links Types of code[edit] There are three types of CPT code: Category I, Category II, and Category III. Category I[edit] Category I CPT Code(s). There are six main sections:[7] Codes for evaluation and management: 99201–99499[edit] (99201–99215) Office/other outpatient services (99217–99220) Hospital observation services (99221–99239) Hospital inpatient services (99241–99255) Consultations (99281–99288) Emergency department services (99291–99292) Critical care services (99304–99318) Nursing facility services (99324–99337) Domiciliary, rest home (boarding home) or custodial care services (99339–99340) Domiciliary, rest home (assisted living facility), or home care plan oversight services (99341–99350) Home health services (99354–99360) Prolonged services (99363–99368) Case management services (99374–99380) Care plan oversight services (99381–99429) Preventive medicine services (99441–99444) Non-face-to-face physician services (99450–99456) Special evaluation and management services (99460–99465) Newborn care services (99466–99480) Inpatient neonatal intensive, and pediatric/neonatal critical, care services (99487–99489) Complex chronic care coordination services (99495–99496) Transitional care management services (99499) Other evaluation and management services Codes for anesthesia: 00100–01999; 99100–99150[edit] (00100–00222) head (00300–00352) neck (00400–00474) thorax (00500–00580) intrathoracic (00600–00670) spine and spinal cord (00700–00797) upper abdomen (00800–00882) lower abdomen (00902–00952) perineum (01112–01190) pelvis (except hip) (01200–01274) upper leg (except knee) (01320–01444) knee and popliteal area (01462–01522) lower leg (below knee) (01610–01682) shoulder and axillary (01710–01782) upper arm and elbow (01810–01860) forearm, wrist and hand (01916–01936) radiological procedures (01951–01953) burn excisions or debridement (01958–01969) obstetric (01990–01999) other procedures (99100–99140) qualifying circumstances for anesthesia (99143–99150) moderate (conscious) sedation Codes for surgery: 10021–69990[edit] (10021–10022) general (10040–19499) integumentary system (20000–29999) musculoskeletal system (30000–32999) respiratory system (33010–37799) cardiovascular system (38100–38999) hemic and lymphatic systems (39000–39599) mediastinum and diaphragm (40490–49999) digestive system (50010–53899) urinary system (54000–55899) male genital system (55920–55980) reproductive system and intersex (56405–58999) female genital system (59000–59899) maternity care and delivery (60000–60699) endocrine system (61000–64999) nervous system (65091–68899) eye and ocular adnexa (69000–69979) auditory system Codes for Radiology: 70010-79999[edit] (70010–76499) diagnostic imaging (76506–76999) diagnostic ultrasound (77001–77032) radiologic guidance (77051–77059) breast mammography (77071–77084) bone/joint studies (77261–77799) radiation oncology (78000–79999) nuclear medicine Codes for pathology and laboratory: 80047–89398[edit] (80047–80076) organ or disease-oriented panels (80100–80103) drug testing (80150–80299) therapeutic drug assays (80400–80440) evocative/suppression testing (80500–80502) consultations (clinical pathology) (81000–81099) urinalysis (82000–84999) chemistry (85002–85999) hematology and coagulation (86000–86849) immunology (86850–86999) transfusion medicine (87001–87999) microbiology (88000–88099) anatomic pathology (postmortem) (88104–88199) cytopathology (88230–88299) cytogenetic studies (88300–88399) surgical pathology (88720–88741) in vivo (transcutaneous) lab procedures (89049–89240) other procedures (89250–89398) reproductive medicine procedures Codes for medicine: 90281–99099; 99151–99199; 99500–99607[edit] (90281–90399) immune globulins, serum or recombinant prods (90465–90474) immunization administration for vaccines/toxoids (90476–90749) vaccines, toxoids (90801–90899) psychiatry (90901–90911) biofeedback (90935–90999) dialysis (91000–91299) gastroenterology (92002–92499) ophthalmology (92502–92700) special otorhinolaryngologic services (92950–93799) cardiovascular (93875–93990) noninvasive vascular diagnostic studies (94002–94799) pulmonary (95004–95199) allergy and clinical immunology (95250–95251) endocrinology (95803–96020) neurology and neuromuscular procedures (96101–96125) central nervous system assessments/tests (neuro-cognitive, mental status, speech testing) (96150–96155) health and behavior assessment/intervention (96360–96549) hydration, therapeutic, prophylactic, diagnostic injections and infusions, and chemotherapy and other highly complex drug or highly complex biologic agent administration (96567–96571) photodynamic therapy (96900–96999) special dermatological procedures (97001–97799) physical medicine and rehabilitation (97802–97804) medical nutrition therapy (97810–97814) acupuncture (98925–98929) osteopathic manipulative treatment (98940–98943) chiropractic manipulative treatment (98960–98962) education and training for patient self-management (98966–98969) non-face-to-face nonphysician services (99000–99091) special services, procedures and reports (99170–99199) other services and procedures (99500–99602) home health procedures/services (99605–99607) medication therapy management services Category II[edit] Category II codes are reviewed by the Performance Measures Advisory Group (PMAG), an advisory body to the CPT Editorial Panel and the CPT/HCPAC Advisory Committee. The PMAG is composed of performance measurement experts representing the Agency for Healthcare Research and Quality (AHRQ), the American Medical Association (AMA), the Centers for Medicare and Medicaid Services (CMS), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the National Committee for Quality Assurance (NCQA) and the Physician Consortium for Performance Improvement. The PMAG may seek additional expertise and/or input from other national health care organizations, as necessary, for the development of Category II codes. These may include national medical specialty societies, other national health care professional associations, accrediting bodies and federal regulatory agencies. Category II codes make use of an alphabetical character as the 5th character in the string (i.e., 4 digits followed by the letter F). These digits are not intended to reflect the placement of the code in the regular (Category I) part of the CPT codebook. Appendix H in CPT section contains information about performance measurement exclusion of modifiers, measures, and the measures' source(s). Currently there are 11 Category II codes. They are: (0001F-0015F) Composite measures (0500F-0575F) Patient management (1000F-1220F) Patient history (2000F-2050F) Physical examination (3006F-3573F) Diagnostic/screening processes or results (4000F-4306F) Therapeutic, preventive or other interventions (5005F-5100F) Follow-up or other outcomes (6005F-6045F) Patient safety (7010F-7025F) Structural Measures CPT II codes are billed in the procedure code field, just as CPT Category I codes are billed. CPT II codes describe clinical components usually included in evaluation and management or clinical services and are not associated with any relative value. Therefore, CPT II codes are billed with a $0.00 billable charge amount.[8] Category III[edit] Category III CPT Code(s) – Emerging technology (Category III codes: 0016T-0207T[9]) Major psychotherapy revisions[edit] The CPT code revisions that affect counselors are simple and straightforward. Here is a list of psychotherapy CPT codes that will be retired, and their 2013 comparables: 90801 –> \ Family therapy codes (90847 and 90846) will remain unchanged, as will codes for psychological testing.[10] Copyright[edit] CPT is a registered trademark of the American Medical Association. The AMA holds the copyright for the CPT coding system.[11] This was upheld in Practice Management v. American Medical Association. Despite the copyrighted nature of the CPT code sets, the use of the code is mandated by almost all health insurance payment and information systems, including the Centers for Medicare and Medicaid Services (CMS) and HIPAA, and the data for the code sets appears in the Federal Register. As a result, it is necessary for most users of the CPT code (principally providers of services) to pay license fees for access to the code.[12] Limited CPT search offered by the AMA[edit] The AMA offers a limited search of the CPT manual for personal, non-commercial use on its web site.[13] See also[edit] Medical classification Procedure code ICD-9 ICD-10-PCS HCPCS Specialty Society Relative Value Scale Update Committee External links[edit] Official site by the AMA Description of the three sections[dead link] from the AMA CPT® Process – How a Code Becomes a Code from the AMA QandA[dead link] from the American Academy of Family Physicians [hide] v t e Medical classification Topographical codes TA TH TE SNOMED T axis MeSH A axis Diagnostic codes general: ICD-10 ICD-9 ICPC-2 NANDA Read codes SNOMED D axis specialized: ICD-O ICSD ICHD ILDS DSM-IV BPA Procedural codes HCPCS (CPT, Level 2) ICD-10 PCS ICD-9-CM Volume 3 NIC SNOMED P axis OPS-301 Read codes/OPCS-4 CCAM ICHI LOINC Pharmaceutical codes ATC NDC SNOMED C axis DIN Outcomes codes NOC Categories: Medical manuals American Medical Association --------------------- SOME GENERAL INFO ABOUT Medical classification From Wikipedia, the free encyclopedia (Redirected from Medical coding) Medical classification, or medical coding, is the process of transforming descriptions of medical diagnoses and procedures into universal medical code numbers. The diagnoses and procedures are usually taken from a variety of sources within the health care record, such as the transcription of the physician's notes, laboratory results, radiologic results, and other sources. Diagnosis codes are used to track diseases and other health conditions, inclusive of chronic diseases such as diabetes mellitus and heart disease, and contagious diseases such as norovirus, the flu, and athlete's foot. These diagnosis and procedure codes are used by government health programs, private health insurance companies, workers' compensation carriers and others. Medical classification systems are used for a variety of applications in medicine, public health and medical informatics, including: statistical analysis of diseases and therapeutic actions reimbursement; e.g., based on diagnosis-related groups knowledge-based and decision support systems direct surveillance of epidemic or pandemic outbreaks There are country specific standards and international classification systems. Contents [hide] 1 Classification types 2 WHO Family of International Classifications 2.1 Reference classifications 2.2 Derived classifications 2.3 Related classifications 3 Other medical classifications 3.1 Diagnosis 3.2 Procedure 3.3 Other 3.3.1 Library classification that have medical components 4 ICD, SNOMED and Electronic Health Record (EHR) 4.1 What is SNOMED? 4.2 What is ICD? 4.3 SNOMED CT vs ICD 4.4 Data Mapping of SNOMED and ICD 5 Clinical Coding in Australia 5.1 What is clinical coding? 5.2 What does clinical coder do? 5.3 What is coded data used for? 6 See also 7 References 8 External links Classification types[edit] Many different medical classifications exist, though they occur into two main groupings: Statistical classifications and Nomenclatures. A statistical classification brings together similar clinical concepts and groups them into categories. The number of categories is limited so that the classification does not become too big. An example of this is used by the International Statistical Classification of Diseases and Related Health Problems (known as ICD). ICD groups diseases of the circulatory system into one "chapter," known as Chapter IX, covering codes I00–I99. One of the codes in this chapter (I47.1) has the code title (rubric) Supraventricular tachycardia. However, there are several other clinical concepts that are also classified here. Among them are paroxysmal atrial tachycardia, paroxysmal junctional tachycardia, auricular tachycardia and nodal tachycardia. Another feature of statistical classifications is the provision of residual categories for "other" and "unspecified" conditions that do not have a specific category in the particular classification. In a nomenclature there is a separate listing and code for every clinical concept. So, in the previous example, each of the tachycardia listed would have its own code. This makes nomenclatures unwieldy for compiling health statistics. Types of coding systems specific to health care include: Diagnostic codes -Are used to determine diseases, disorders, and symptoms -Can be used to measure morbidity and mortality Examples: ICD-9-CM, ICD-10 Procedural codes -They are numbers or alphanumeric codes used to identify specific health interventions taken by medical professionals. Examples: ICPM, ICHI Pharmaceutical codes -Are used to identify medications Examples: AT, NDC Topographical codes -Are codes that indicate a specific location in the body Examples :ICD-O, SNOMED WHO Family of International Classifications[edit] The World Health Organization (WHO) maintains several internationally endorsed classifications designed to facilitate the comparison of health related data within and across populations and over time as well as the compilation of nationally consistent data.[1] This "Family of International Classifications" (FIC) include three main (or reference) classifications on basic parameters of health prepared by the organization and approved by the World Health Assembly for international use, as well as a number of derived and related classifications providing additional details. Some of these international standards have been revised and adapted by various countries for national use. Reference classifications[edit] International Statistical Classification of Diseases and Related Health Problems (ICD)[2] ICD-9 (9th revision, published in 1977) ICD-9-CM (Clinical Modification, used in the US) ICD-10 (10th revision, in use by WHO since 1994) ICD-10-CM (Clinical Modification, used in the US) ICD-10-PCS (Procedure Coding System, used in the US) ICD-10-CA (used for morbidity classification in Canada).[3] ICD-10-AM (used in Australia and New Zealand)[4] EUROCAT - an extension of the ICD-10 Q chapter for congenital disorders International Classification of Functioning, Disability and Health (ICF) International Classification of Health Interventions (ICHI) (previously known as International Classification of Procedures in Medicine)[5] Derived classifications[edit] Derived classifications are based on the WHO reference classifications (i.e. ICD and ICF).[1] They include the following: International Classification of Diseases for Oncology, Third Edition (ICD-O-3) ICD-10 for Mental and Behavioural Disorders[6] Application of the International Classification of Diseases to Dentistry and Stomatology, 3rd Edition (ICD-DA)[7] Application of the International Classification of Diseases to Neurology (ICD-10-NA)[8] Related classifications[edit] Related classifications in the WHO-FIC are those that partially refer to the reference classifications, e.g. only at specific levels.[1] They include: International Classification of Primary Care (ICPC)[9] ICPC-2 PLUS International Classification of External Causes of Injury (ICECI)[10] Anatomical Therapeutic Chemical Classification System with Defined Daily Doses (ATC/DDD) Technical aids for persons with disabilities: Classification and terminology (ISO9999)[11] International Classification for Nursing Practice (ICNP)[12] Other medical classifications[edit] Diagnosis[edit] The categories in a diagnosis classification classify [ and medical signs. In addition to the ICD and its national variants, they include: Diagnostic and Statistical Manual of Mental Disorders (DSM) DSM-IV Codes International Classification of Headache Disorders 2nd Edition (ICHD-II)[13] International Classification of Sleep Disorders (ICSD) Online Mendelian Inheritance in Man, database of genetic codes Read codes Systematized Nomenclature of Medicine - Clinical Terms (SNoMed-CT) Procedure[edit] The categories in a procedure classification classify specific health interventions undertaken by health professionals. In addition to the ICHI and ICPC, they include: Australian Classification of Health Interventions (ACHI) Canadian Classification of Health Interventions (CCI)[14] Chinese Classification of Heath Interventions (CCHI) Current Procedural Terminology (CPT) Health Care Procedure Coding System (HCPCS) ICD-10 Procedure Coding System (ICD-10-PCS) Office of Population, Censuses and Surveys Classification of Surgical Operations and Procedures (OPCS-4) Other[edit] Classification of Pharmaco-Therapeutic Referrals (CPR) Logical Observation Identifiers Names and Codes (LOINC), standard for identifying medical laboratory observations Medical Dictionary for Regulatory Activities (MedDRA) Medical Subject Headings (MeSH) List of MeSH codes Nursing Interventions Classification (NIC) Nursing Outcomes Classification (NOC) TIME-ITEM, ontology of topics in medical education TNM Classification of Malignant Tumors Unified Medical Language System (UMLS) Victoria Ambulatory Coding System (VACS) / Queensland Ambulatory Coding System (QACS), Australia[citation needed] Library classification that have medical components[edit] Dewey Decimal System and Universal Decimal Classification (section 610–620) National Library of Medicine classification ICD, SNOMED and Electronic Health Record (EHR)[edit] What is SNOMED?[edit] The Systematized Nomenclature of Medicine (SNOMED) is the most widely recognised nomenclature in healthcare.[15] Its current version, SNOMED Clinical Terms (SNOMED CT), is intended to provide a set of concepts and relationships that offers a common reference point for comparison and aggregation of data about the health care process.[16] SNOMED CT is often described as a reference terminology.[17] SNOMED CT contains more than 311,000 active concepts with unique meanings and formal logic-based definitions organised into hierarchies.[16] SNOMED CT can be used by anyone with an Affiliate License, 40 low income countries defined by the World Bank or qualifying research, humanitarian and charitable projects.[16] SNOMED-CT is designed to be managed by computer, and it is a complex relationship concepts.[15] What is ICD?[edit] The International Classification of Disease (ICD) is the most widely recognized medical classification maintained by the World Health Organization (WHO).[18] Its primary purpose is to categorise diseases for morbidity and mortality reporting. The United States has used a clinical modification of ICD (ICD-9-CM) for the additional purposes of reimbursement. ICD-10 was endorsed by WHO in 1990, and WHO Member states began using the classification system in 1994 for both morbidity and mortality reporting. In the US, however, it has only been used for reporting mortality since 1999. Because of the US delay in adopting its version of ICD-10, it is currently unable to compare morbidity data with the rest of the world. ICD has a hierarchical structure, and coding in this context, is the term applied when representations are assigned to the words they represent.[18] Coding diagnoses and procedures is the assignment of codes from a code set that follows the rules of the underlying classification or other coding guidelines. SNOMED CT vs ICD[edit] SNOMED CT and ICD are designed for different purposes and each should each be used for the purposes for which it was designed.[19] As a core terminology for the EHR, SNOMED CT provides a common language that enables a consistent language that enables a consistent way of capturing, sharing, and aggregating health data across specialties and sites of care.[20] It is highly detailed terminology designed for input not reporting. Classification systems such as ICD-9-CM, ICD-10-CM, and ICD-10-PCS group together similar diseases and procedures and organise related entities for easy retrieval.[20] They are typically used for external reporting requirements or other uses where data aggregation is advantageous, such as measuring the quality of care monitoring resource utilisation, or processing claims for reimbursement. SNOMED is clinically-based, document whatever is needed for patient care and has better clinical coverage than ICD. ICD’s focus is statistical with less common diseases get lumped together in “catch-all” categories, which result in loss of information. SNOMED CT is used directly by healthcare providers during the process of care, whereas ICD is used by coding professionals after the episode of care. SNOMED CT had multiple hierarchy, whereas single hierarchy for ICD. SNOMED CT concepts are defined logically by their attributes, whereas only textual rules and definitions in ICD.[20] Data Mapping of SNOMED and ICD[edit] SNOMED and ICD can be coordinated. The National Library of Medicine (NLM) maps ICD-9-CM, ICD-10-CM, ICD-10-PCS, and other classification systems to SNOMED.[21] Data Mapping is the process of identifying relationships between two distinct data models. The full value of the health information contained in an EHR system will only be realised if both systems involved in the map are up to date and accurately reflect the current practice of medicine.[18] Clinical Coding in Australia[edit] Medical coding and classification systems are expected to become increasingly important in the health care sector. Together with and as an integrated part of the electronic health information systems, the coding and classification systems will be used to improve the quality and effectiveness of the medical services.[22] What is clinical coding?[edit] Clinical coding is the translation of written, scanned and/or electronic clinical documentation about patient care into code format. For example, hypertension is represented by the code 'I10'; general anaethesia is represented by the code'92514-XX[1910]'. A standardised classification system, The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM), is applied in all Australian acute health facilities. It is based on the World Health Organisation (WHO) ICD-10 system, updated with the Australian Classification of Health Interventions (ACHI), Australian Coding Standards (ACS). Clinical coding is a specialised skill requiring excellent knowledge of medical terminology and disease processes, attention to detail, and analytical skills.[23] What does clinical coder do?[edit] A clinical coder is responsible for abstracting relevant information from the medical record and deciding which diagnoses and procedures meet criteria for coding as per Australian and State Coding Standards. The coder then assigns codes for these diagnoses and procedures based on ICD-10-AM conventions and standards.[23] What is coded data used for?[edit] The assigned codes and other patient data are processed by grouper software to determine a diagnosis-related group (DRG) for the episode of care, which is used for funding and reimbursement. This process allows hospital episodes to be grouped into meaningful categories, helping us to better match patient needs to health care resources.[24] See also[edit] Acronyms in healthcare Ambulatory Payment Classification, US billing system for outpatient services Biological database Classification of mental disorders Clinical coder German Institute for Medical Documentation and Information Health information management Health informatics Human resources for health information system List of international common standards Medical dictionary North American Nursing Diagnosis Association (professional organization) Nosology External links[edit] WHO Family of International Classifications official site Medical terminologies at the National Library of Medicine [show] v t e Medical classification [hide] v t e Health informatics Health information management Electronic health record Personal health record Clinic management system Hospital information system DICOM Health information technology Regional Health Information Organization Computerized physician order entry subdisciplines Bioinformatics Translational medicine Computational biology Public health informatics Medical classification ICD LOINC HRHIS Continuity of Care Record ISO 27799 Professional organizations International Medical Informatics Association Australasian College of Health Informatics Brazilian Society of Health Informatics Indian Association for Medical Informatics American Medical Informatics Association European Federation for Medical Informatics other concepts Health Level 7 List of medical and health informatics journals Categories: Medical classification Nursing classification ------------------------ SOME GENERAL INFO ABOUT Medical diagnosis From Wikipedia, the free encyclopedia Radiography is an important tool in diagnosis of certain disorders. Medical diagnosis (often abbreviated dx or Dx) is diagnosis in the field of medicine, that is, the determination of which disease or condition is causing a person's signs and symptoms. It is called simply diagnosis when the medical context is implicit. Both the process of determining which disease or condition is present and the conclusion that is reached by this process are called "diagnosis" (for example, the process of diagnosis can yield a diagnosis of strep throat). The foundation of diagnosis is always the information from the history and the physical examination, but often one or more diagnostic procedures, such as diagnostic tests, are also done during the process. Diagnosis is often challenging, because many signs and symptoms are nonspecific. For example, redness of the skin (erythema), by itself, is a sign of many disorders and thus doesn't tell the physician what is wrong. Thus differential diagnosis, in which several possible explanations are compared and contrasted, must be performed. This involves the correlation of various pieces of information followed by the recognition and differentiation of patterns. Occasionally the process is made easy by a sign or symptom (or a group of several) that is pathognomonic. Diagnosis is a major component of the procedure of a doctor's visit. From the point of view of statistics, the diagnostic procedure involves classification tests. Contents [hide] 1 History and etymology 1.1 Diagnostic procedures 1.2 Diagnostic opinion 2 Indication for diagnostic procedure 3 General components 4 Specific methods 4.1 Differential diagnosis 4.2 Pattern recognition 4.3 Diagnostic criteria 4.4 Clinical decision support system 4.5 Other diagnostic procedure methods 5 Diagnostic opinion and its effects 6 Additional types of diagnosis 7 Overdiagnosis 8 Errors 9 Lag time 10 See also 10.1 Lists 11 References 12 External links History and etymology[edit] Main article: History of medical diagnosis The history of medical diagnosis began in earnest from the days of Imhotep in ancient Egypt and Hippocrates in ancient Greece. In Traditional Chinese Medicine, there are four diagnostic methods: inspection, auscultation-olfaction, interrogation, and palpation.[1] A Babylonian medical textbook, the Diagnostic Handbook written by Esagil-kin-apli (fl. 1069-1046 BC), introduced the use of empiricism, logic and rationality in the diagnosis of an illness or disease.[2] The book made use of logical rules in combining observed symptoms on the body of a patient with its diagnosis and prognosis.[3] Esagil-kin-apli described the symptoms for many varieties of epilepsy and related ailments along with their diagnosis and prognosis.[4] The plural of diagnosis is diagnoses, the verb is to diagnose, and a person who diagnoses is called a diagnostician. The word diagnosis /da?.?g'no?s?s/ is derived through Latin from the Greek word d?a?????s?e?, meaning to discern or distinguish.[5] The practice of diagnosis continues to be dominated by theories set down in the early 20th century.[citation needed] Medical diagnosis or the actual process of making a diagnosis is a cognitive process. A clinician uses several sources of data and puts the pieces of the puzzle together to make a diagnostic impression. The initial diagnostic impression can be a broad term describing a category of diseases instead of a specific disease or condition. After the initial diagnostic impression, the clinician obtains follow up tests and procedures to get more data to support or reject the original diagnosis and will attempt to narrow it down to a more specific level. Diagnostic procedures are the specific tools that the clinicians use to narrow the diagnostic possibilities. Diagnostic procedures[edit] A diagnosis, in the sense of diagnostic procedure, can be regarded as an attempt at classification of an individual's condition into separate and distinct categories that allow medical decisions about treatment and prognosis to be made. Subsequently, a diagnostic opinion is often described in terms of a disease or other condition, but in the case of a wrong diagnosis, the individual's actual disease or condition is not the same as the individual's diagnosis. A diagnostic procedure may be performed by various health care professionals such as a physician, physical therapist, optometrist, healthcare scientist, chiropractor, dentist, podiatrist, nurse practitioner, or physician assistant. This article uses diagnostician as any of these person categories. A diagnostic procedure (as well as the opinion reached thereby) does not necessarily involve elucidation of the etiology of the diseases or conditions of interest, that is, what caused the disease or condition. Such elucidation can be useful to optimize treatment, further specify the prognosis or prevent recurrence of the disease or condition in the future. Diagnostic opinion[edit] However, a diagnosis can take many forms.[6] It might be a matter of naming the disease, lesion, dysfunction or disability. It might be a management-naming or prognosis-naming exercise. It may indicate either degree of abnormality on a continuum or kind of abnormality in a classification. It’s influenced by non-medical factors such as power, ethics and financial incentives for patient or doctor. It can be a brief summation or an extensive formulation, even taking the form of a story or metaphor. It might be a means of communication such as a computer code through which it triggers payment, prescription, notification, information or advice. It might be pathogenic or salutogenic. It’s generally uncertain and provisional. Indication for diagnostic procedure[edit] The initial task is to detect a medical indication to perform a diagnostic procedure. Indications include: Detection of any deviation from what is known to be normal, such as can be described in terms of, for example, anatomy (the structure of the human body), physiology (how the body works), pathology (what can go wrong with the anatomy and physiology), psychology (thought and behavior) and human homeostasis (regarding mechanisms to keep body systems in balance). Knowledge of what is normal and measuring of the patient's current condition against those norms can assist in determining the patient's particular departure from homeostasis and the degree of departure, which in turn can assist in quantifying the indication for further diagnostic processing. A complaint expressed by a patient. The fact that a patient has sought a diagnostician can itself be an indication to perform a diagnostic procedure. Therefore, in, for example, a doctor's visit, the physician may already start performing a diagnostic procedure by, for example, watching the gait of the patient from the waiting room to the doctor's office even before she or he has started to present any complaints. Even during an already ongoing diagnostic procedure, there can be an indication to perform another, separate, diagnostic procedure for another, potentially concomitant, disease or condition. This may occur as a result of an incidental finding of a sign unrelated to the parameter of interest, such as can occur in comprehensive tests such as radiological studies like magnetic resonance imaging or blood test panels that also include blood tests that are not relevant for the ongoing diagnosis. General components[edit] General components, which are present in a diagnostic procedure in most of the various available methods include: Complementing the already given information with further data gathering, which may include questions of the medical history (potentially from other people close to the patient as well), physical examination and various diagnostic tests. A diagnostic test is any kind of medical test performed to aid in the diagnosis or detection of disease. Diagnostic tests can also be used to provide prognostic information on people with established disease.[7] Processing of the answers, findings or other results. Consultations with other providers and specialists in the field may be sought. Specific methods[edit] There are a number of methods or techniques that can be used in a diagnostic procedure, including performing a differential diagnosis or following medical algorithms.[8] In reality, a diagnostic procedure may involve components of multiple methods.[9] Differential diagnosis[edit] Main article: Differential diagnosis The method of differential diagnosis is based on finding as many candidate diseases or conditions as possible that can possibly cause the signs or symptoms, followed by a process of elimination or at least of rendering the entries more or less probable by further medical tests and other processing until, aiming to reach the point where only one candidate disease or condition remains as probable. The final result may also remain a list of possible conditions, ranked in order of probability or severity. The resultant diagnostic opinion by this method can be regarded more or less as a diagnosis of exclusion. Even if it doesn't result in a single probable disease or condition, it can at least rule out any imminently life-threatening conditions. Unless the provider is certain of the condition present, further medical tests, such as medical imaging, are performed or scheduled in part to confirm or disprove the diagnosis but also to document the patient's status and keep the patient's medical history up to date. If unexpected findings are made during this process, the initial hypothesis may be ruled out and the provider must then consider other hypotheses. Pattern recognition[edit] In a pattern recognition method the provider uses experience to recognize a pattern of clinical characteristics.[8] It is mainly based on certain symptoms or signs being associated with certain diseases or conditions, not necessarily involving the more cognitive processing involved in a differential diagnosis. This may be the primary method used in cases where diseases are "obvious", or the provider's experience may enable him or her to recognize the condition quickly. Theoretically, a certain pattern of signs or symptoms can be directly associated with a certain therapy, even without a definite decision regarding what is the actual disease, but such a compromise carries a substantial risk of missing a diagnosis which actually has a different therapy so it may be limited to cases where no diagnosis can be made. Diagnostic criteria[edit] The term diagnostic criteria designates the specific combination of signs, symptoms, and test results that the clinician uses to attempt to determine the correct diagnosis. Some examples of diagnostic criteria are: Amsterdam criteria for hereditary nonpolyposis colorectal cancer McDonald criteria for multiple sclerosis ACR criteria for systemic lupus erythematosus Centor criteria for strep throat Clinical decision support system[edit] Clinical decision support systems are interactive computer programs designed to assist health professionals with decision-making tasks. The clinician interacts with the software utilizing both the clinician’s knowledge and the software to make a better analysis of the patients data than either human or software could make on their own. Typically the system makes suggestions for the clinician to look through and the clinician picks useful information and removes erroneous suggestions.[10] Other diagnostic procedure methods[edit] Other methods that can be used in performing a diagnostic procedure include: An example of a medical algorithm for assessment and treatment of overweight and obesity. Usage of medical algorithms An "exhaustive method", in which every possible question is asked and all possible data is collected.[8] Use of a sensory pill that collects and transmits physiological information after being swallowed.[11] Using optical coherence tomography to produce detailed images of the brain or other soft tissue, through a "window" made of zirconia that has been modified to be transparent and implanted in the skull.[12] Diagnostic opinion and its effects[edit] Once a diagnostic opinion has been reached, the provider is able to propose a management plan, which will include treatment as well as plans for follow-up. From this point on, in addition to treating the patient's condition, the provider can educate the patient about the etiology, progression, prognosis, other outcomes, and possible treatments of her or his ailments, as well as providing advice for maintaining health. A treatment plan is proposed which may include therapy and follow-up consultations and tests to monitor the condition and the progress of the treatment, if needed, usually according to the medical guidelines provided by the medical field on the treatment of the particular illness. Relevant information should be added to the medical record of the patient. A failure to respond to treatments that would normally work may indicate a need for review of the diagnosis. Additional types of diagnosis[edit] Sub-types of diagnoses include: Clinical diagnosis A diagnosis made on the basis of medical signs and patient-reported symptoms, rather than diagnostic tests Laboratory diagnosis A diagnosis based significantly on laboratory reports or test results, rather than the physical examination of the patient. For instance, a proper diagnosis of infectious diseases usually requires both an examination of signs and symptoms, as well as laboratory characteristics of the pathogen involved. Radiology diagnosis A diagnosis based primarily on the results from medical imaging studies. Greenstick fractures are common radiological diagnoses. Principal diagnosis The single medical diagnosis that is most relevant to the patient's chief complaint or need for treatment. Many patients have additional diagnoses. Admitting diagnosis The diagnosis given as the reason why the patient was admitted to the hospital; it may differ from the actual problem or from the discharge diagnoses, which are the diagnoses recorded when the patient is discharged from the hospital. Differential diagnosis A process of identifying all of the possible diagnoses that could be connected to the signs, symptoms, and lab findings, and then ruling out diagnoses until a final determination can be made. Diagnostic criteria Designates the combination of signs, symptoms, and test results that the clinician uses to attempt to determine the correct diagnosis. They are standards, normally published by international committees, and they are designed to offer the best sensitivity and specificity possible, respect the presence of a condition, with the state-of-the-art technology. Prenatal diagnosis Diagnosis work done before birth Diagnosis of exclusion A medical condition whose presence cannot be established with complete confidence from either examination or testing. Diagnosis is therefore by elimination of all other reasonable possibilities. Dual diagnosis The diagnosis of two related, but separate, medical conditions or co-morbidities; the term almost always refers to a diagnosis of a serious mental illness and a substance addiction. Self-diagnosis The diagnosis or identification of a medical conditions in oneself. Self-diagnosis is very common and typically accurate for everyday conditions, such as headaches, menstrual cramps, and headlice. Remote diagnosis A type of telemedicine that diagnosis a patient without being physically in the same room as the patient. Nursing diagnosis Rather than focusing on biological processes, a nursing diagnosis identifies people's responses to situations in their lives, such as a readiness to change or a willingness to accept assistance. Computer-aided diagnosis Providing symptoms allows the computer to identify the problem and diagnose the user to the best of its ability. Health screening begins by identifying the part of the body where the symptoms are located; the computer cross-references a database for the corresponding disease and presents a diagnosis.[13] Overdiagnosis The diagnosis of "disease" that will never cause symptoms, distress, or death during a patient's lifetime Wastebasket diagnosis A vague, or even completely fake, medical or psychiatric label given to the patient or to the medical records department for essentially non-medical reasons, such as to reassure the patient by providing an official-sounding label, to make the provider look effective, or to obtain approval for treatment. This term is also used as a derogatory label for disputed, poorly described, overused, or questionably classified diagnoses, such as pouchitis and senility, or to dismiss diagnoses that amount to overmedicalization, such as the labeling of normal responses to physical hunger as reactive hypoglycemia. Retrospective diagnosis The labeling of an illness in a historical figure or specific historical event using modern knowledge, methods and disease classifications. Overdiagnosis[edit] Main article: Overdiagnosis Overdiagnosis is the diagnosis of "disease" that will never cause symptoms or death during a patient's lifetime. It is a problem because it turns people into patients unnecessarily and because it can lead to economic waste (overutilization) and treatments that may cause harm. Overdiagnosis occurs when a disease is diagnosed correctly, but the diagnosis is irrelevant. A correct diagnosis may be irrelevant because treatment for the disease is not available, not needed, or not wanted. Errors[edit] Further information: Medical error Causes and factors of error in diagnosis are:[14] the manifestation of disease are not sufficiently noticeable a disease is omitted from consideration too much significance is given to some aspect of the diagnosis the condition is a rare disease with symptoms suggestive of many other conditions the condition has a rare presentation Lag time[edit] When making a medical diagnosis, a lag time is a delay in time until a step towards diagnosis of a disease or condition is made. Types of lag times are mainly: Onset-to-medical encounter lag time, the time from onset of symptoms until visiting a health care provider[15] Encounter-to-diagnosis lag time, the time from first medical encounter to diagnosis[15] See also[edit] Diagnosis codes Diagnosis-related group Diagnostic and Statistical Manual of Mental Disorders Doctor-patient relationship Etiology (medicine) International Statistical Classification of Diseases and Related Health Problems (ICD) Medical classification Merck Manual of Diagnosis and Therapy Misdiagnosis and medical error Nosology Nursing diagnosis Pathogenesis Pathology Preimplantation genetic diagnosis Lists[edit] List of diagnostic classification and rating scales used in psychiatry List of diseases List of disorders List of medical symptoms Category:Diseases External links[edit] Look up diagnosis in Wiktionary, the free dictionary. How A Diagnosis Works [show] v t e Basic medical terms used to describe disease conditions [show] v t e Medical examination and history taking [show] v t e Health care Categories: Medical diagnosis Medical terminology Nosology Advanced practice registered nursing --------------------- SOME GENERAL INFO ABOUT Nosology From Wikipedia, the free encyclopedia This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (January 2010) Nosology (from Ancient Greek ??s?? (nosos), meaning "disease", and -????a (-logia), meaning "study of-") is a branch of medicine that deals with classification of diseases. Contents [hide] 1 Types of classification 2 History 3 Applications 4 See also 5 References 6 External links Types of classification[edit] Diseases may be classified by etiology (cause), pathogenesis (mechanism by which the disease is caused), or by symptom(s). Alternatively, diseases may be classified according to the organ system involved, though this is often complicated since many diseases affect more than one organ. A chief difficulty in nosology is that diseases often cannot be defined and classified clearly, especially when etiology or pathogenesis are unknown. Thus diagnostic terms often only reflect a symptom or set of symptoms (syndrome). Disease is not a fixed entity but an ever changing process like that of life itself. Disease is an abstraction made by our mental concept;the factual reality is the diseased person. Must read Classification of disease by Dr. Samuel Hahnemann (Father of Homeopathy) History[edit] The Ayurveda is a collection of early Indian works about medicine. In China the Huangdi Neijing is another ancient text. In the West, Hippocrates was one of the earliest writers on the subject of disease. The book of Leviticus also includes an early discussion of the treatment of skin diseases. See Metzora (parsha) In the 10th century the Arabian psychologist Najab ud-din Unhammad classified a nosology of nine major categories of mental disorders, which included 30 different mental illnesses in total. Some of the categories he described included obsessive-compulsive disorders, delusional disorders, degenerative diseases, involutional melancholia, and states of abnormal excitement.[1][verification needed] In the 18th century, the taxonomist Carolus Linnaeus, Francois Boissier de Sauvages, and psychiatrist Philippe Pinel developed an early classification of physical illnesses. Thomas Sydenham's work in the late 17th century might also be considered a nosology. In the 19th century, Emil Kraepelin and then Jacques Bertillon developed their own nosologies. Bertillon's work, classifying causes of death, was a precursor of the modern code system, the International Classification of Diseases. The early nosological efforts grouped diseases by their symptoms, whereas modern systems (e.g. SNOMED) focus on grouping diseases by the anatomy and etiology involved. Applications[edit] Nosology is used extensively in public health, to allow epidemiological studies of public health issues. Analysis of death certificates requires nosological coding of causes of death. Nosological classifications are used in medical administration, such as filing of health insurance claims, and patient records, among others See also[edit] Clinical coder Differential diagnosis International Statistical Classification of Diseases and Related Health Problems (ICD) ICD-10 (ICD 10th Revision) Medical classification Pathology (study of disease) Category:Diseases and disorders (Wikipedia's categorization of diseases) References[edit] Jump up ^ Millon, Theodore (2004), Masters of the Mind: Exploring the Story of Mental Illness from Ancient Times to the New Millennium, John Wiley & Sons, p. 38, ISBN 978-0-471-46985-8 External links[edit] Gordon L. Snider, Nosology for Our Day Its Application to Chronic Obstructive Pulmonary Disease, American Journal of Respiratory and Critical Care Medicine Vol 167. pp. 678–683, (2003). fulltext C. S. Herrman, The Bipolar Spectrum, SSRN (Social Science Research Network, 5 August 2010) [1] Nosology.net: An online resource for nosologic diagnostic systems. This site also demonstrates how the proposed system can be used currently in Neurology and Psychiatry International Classification of Diseases by the World Health Organization. [2] Categories: Medical terminology Nosology SOME GENERAL INFO ABOUT Laboratories From Wikipedia, the free encyclopedia This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (July 2007) This article may be expanded with text translated from the corresponding article in the German Wikipedia. (September 2013) Click [show] on the right to read important instructions before translating.[show] A medical laboratory run by the Graduate Institute of Cancer Biology of China Medical University (Taiwan) Molecular Biology Technics Laboratory at Faculty of Biology of Adam Mickiewicz University in Poznan A workbench in a chemistry laboratory The Schuster Laboratory, University of Manchester (a physics laboratory) A laboratory (/l?'b?r?t?ri/ or /'laeb?r?tri/; informally, lab) is a facility that provides controlled conditions in which scientific or technological research, experiments, and measurement may be performed. Labs used for scientific research take many forms because of the differing requirements of specialists in the various fields of science and engineering. A physics lab might contain a particle accelerator or vacuum chamber, while a metallurgy lab could have apparatus for casting or refining metals or for testing their strength. A chemist or biologist might use a wet laboratory, while a psychologist's lab might be a room with one-way mirrors and hidden cameras in which to observe behavior. In some laboratories, such as those commonly used by computer scientists, computers (sometimes supercomputers) are used for either simulations or the analysis of data collected elsewhere. Scientists in other fields will use still other types of laboratories. Engineers use labs as well to design, build, and test technological devices. Despite the great differences among laboratories, some features are common. The use of workbenches or countertops at which scientists may choose to either sit or stand is a common way to ensure comfortable working conditions. Cabinets for the storage of laboratory equipment are also found in laboratories. It is traditional for a scientist to record an experiment's progress in a laboratory notebook, but modern labs almost always contain at least one computer workstation for data collection and analysis. Scientific laboratories can be found in schools and universities, in industry, in government or military facilities, and even aboard ships and spacecraft. A laboratory might offer work space for just one to more than thirty researchers depending on its size and purpose. Recently, a new type of laboratory called Open Laboratory has emerged.[when?] Its format allows the sharing of space, equipment, support staff between different research groups and also fosters information exchange through communications across fields. There is also an open source lab, which is a lab that is made up of open source scientific hardware.[1][2] Contents [hide] 1 History 2 Techniques 3 Equipment 4 Specialised types 5 Safety 6 See also 7 References 8 External links History[edit] [icon] This section requires expansion. (February 2013) Chemistry laboratory of the 18th century, of the sort used by Antoine Lavoisier and his contemporaries Thomas Edison in his laboratory, 1901 A laboratory in the 1970s Techniques[edit] Laboratory techniques are the sum of procedures used on natural sciences such as chemistry, biology, physics in order to conduct an experiment, all of them follow scientific method; while some of them involves the use of complex laboratory equipment from laboratory glassware to electrical devices others require such specific or expensive supplies. Equipment[edit] Three beakers, an Erlenmeyer flask, a graduated cylinder and a volumetric flask Laboratory equipment refers to the various tools and equipment used by scientists working in a laboratory. These include tools such as Bunsen burners, and microscopes as well as specialty equipment such as operant conditioning chambers, spectrophotometers and calorimeters. Another important type of laboratory equipment is laboratory glassware such as the beaker or reagent bottle, or even a thermometer. Laboratory equipment is generally used to either perform an experiment or to take measurements and gather data. Larger or more sophisticated equipment is generally called a scientific instrument. Specialised types[edit] The title of laboratory is also used for certain other facilities where the processes or equipment used are similar to those in scientific laboratories. These notably include: film laboratory or darkroom clandestine lab for the production of illegal drugs computer lab crime lab used to process crime scene evidence media lab medical lab (involves handling of chemical compounds) public health lab In recent years government and private centers for innovation in learning, leadership and organization have adopted "lab" in their name to emphasize the experimental and research-oriented nature of their work. Safety[edit] An eyewash station in a laboratory. In some laboratories, the conditions are no more dangerous than in any other room. In many labs, though, hazards are present. Laboratory hazards are as varied as the subjects of study in laboratories, and might include poisons; infectious agents; flammable, explosive, or radioactive materials; moving machinery; extreme temperatures; lasers, strong magnetic fields or high voltage. In laboratories where dangerous conditions might exist, safety precautions are important. Rules exist to minimize the individual's risk, and safety equipment is used to protect the lab user from injury or to assist in responding to an emergency. The Occupational Safety and Health Administration (OSHA) in the United States, recognizing the unique characteristics of the laboratory workplace, has tailored a standard for occupational exposure to hazardous chemicals in laboratories. This standard is often referred to as the "Laboratory Standard". Under this standard, a laboratory is required to produce a Chemical Hygiene Plan (CHP) which addresses the specific hazards found in its location, and its approach to them. In determining the proper Chemical Hygiene Plan for a particular business or laboratory, it is necessary to understand the requirements of the standard, evaluation of the current safety, health and environmental practices and assessment of the hazards. The CHP must be reviewed annually. Many schools and businesses employ safety, health, and environmental specialists, such as a Chemical Hygiene Officer (CHO) to develop, manage, and evaluate their CHP. Additionally, third party review is also used to provide an objective "outside view" which provides a fresh look at areas and problems that may be taken for granted or overlooked due to habit. Inspections and audits like also be conducted on a regular basis to assess hazards due to chemical handling and storage, electrical equipment, biohazards, hazardous waste management, chemical waste, housekeeping and emergency preparedness, radiation safety, ventilation as well as respiratory testing and indoor air quality. An important element of such audits is the review of regulatory compliance and the training of individuals who have access to and/or work in the laboratory. Training is critical to the ongoing safe operation of the laboratory facility. Educators, staff and management must be engaged in working to reduce the likelihood of accidents, injuries and potential litigation. Efforts are made to ensure laboratory safety videos are both relevant and engaging.[3] See also[edit] Chemical accident Contamination control Controlled lab reactor Environmental health Fume hood to limit exposure to hazardous or toxic fumes, vapors or dusts Hackspace ISO/IEC 17025 Lab website Workshop References[edit] Jump up ^ Joshua M. Pearce,Open-Source Lab:How to Build Your Own Hardware and Reduce Research Costs, Elsevier, 2014. ISBN: 9780124104624 Jump up ^ Joshua M. Pearce, “Building Research Equipment with Free, Open-Source Hardware.” Science 337 (6100): 1303–1304 (2012). Jump up ^ Michael L. Matson, Jeffrey P. Fitzgerald, Shirley Lin (October 1, 2007). "Creating Customized, Relevant, and Engaging Laboratory Safety Videos". Journal of Chemical Education 84 (10): 1727. Bibcode:2007JChEd..84.1727M. doi:10.1021/ed084p1727. Retrieved 22 February 2013. External links[edit] The dictionary definition of laboratory at Wiktionary Media related to Laboratory at Wikimedia Commons Nobel Laureates Interactive 360° Laboratories [show] v t e Laboratory equipment Categories: Laboratories ------------------------------------ SOME GENERAL INFO ABOUT Current Procedural Terminology From Wikipedia, the free encyclopedia The Current Procedural Terminology (CPT) code set is a medical code set maintained by the American Medical Association through the CPT Editorial Panel.[1] The CPT code set (copyright protected by the AMA) describes medical, surgical, and diagnostic services and is designed to communicate uniform information about medical services and procedures among physicians, coders, patients, accreditation organizations, and payers for administrative, financial, and analytical purposes. New editions are released each October.[2] The current version is the CPT 2014. It is available in both a standard edition and a professional edition.[3][4] CPT coding is similar to ICD-9 and ICD-10 coding, except that it identifies the services rendered rather than the diagnosis on the claim. ICD code sets also contain procedure codes but these are only used in the inpatient setting.[5] CPT is currently identified by the Centers for Medicare and Medicaid Services (CMS)[6] as Level 1 of the Health Care Procedure Coding System. The Current Procedural Terminology (CPT) was developed by the American Medical Association (AMA).[6] Contents [hide] 1 Types of code 1.1 Category I 1.1.1 Codes for evaluation and management: 99201–99499 1.1.2 Codes for anesthesia: 00100–01999; 99100–99150 1.1.3 Codes for surgery: 10021–69990 1.1.4 Codes for Radiology: 70010-79999 1.1.5 Codes for pathology and laboratory: 80047–89398 1.1.6 Codes for medicine: 90281–99099; 99151–99199; 99500–99607 1.2 Category II 1.3 Category III 2 Major psychotherapy revisions 3 Copyright 3.1 Limited CPT search offered by the AMA 4 See also 5 References 6 External links Types of code[edit] There are three types of CPT code: Category I, Category II, and Category III. Category I[edit] Category I CPT Code(s). There are six main sections:[7] Codes for evaluation and management: 99201–99499[edit] (99201–99215) Office/other outpatient services (99217–99220) Hospital observation services (99221–99239) Hospital inpatient services (99241–99255) Consultations (99281–99288) Emergency department services (99291–99292) Critical care services (99304–99318) Nursing facility services (99324–99337) Domiciliary, rest home (boarding home) or custodial care services (99339–99340) Domiciliary, rest home (assisted living facility), or home care plan oversight services (99341–99350) Home health services (99354–99360) Prolonged services (99363–99368) Case management services (99374–99380) Care plan oversight services (99381–99429) Preventive medicine services (99441–99444) Non-face-to-face physician services (99450–99456) Special evaluation and management services (99460–99465) Newborn care services (99466–99480) Inpatient neonatal intensive, and pediatric/neonatal critical, care services (99487–99489) Complex chronic care coordination services (99495–99496) Transitional care management services (99499) Other evaluation and management services Codes for anesthesia: 00100–01999; 99100–99150[edit] (00100–00222) head (00300–00352) neck (00400–00474) thorax (00500–00580) intrathoracic (00600–00670) spine and spinal cord (00700–00797) upper abdomen (00800–00882) lower abdomen (00902–00952) perineum (01112–01190) pelvis (except hip) (01200–01274) upper leg (except knee) (01320–01444) knee and popliteal area (01462–01522) lower leg (below knee) (01610–01682) shoulder and axillary (01710–01782) upper arm and elbow (01810–01860) forearm, wrist and hand (01916–01936) radiological procedures (01951–01953) burn excisions or debridement (01958–01969) obstetric (01990–01999) other procedures (99100–99140) qualifying circumstances for anesthesia (99143–99150) moderate (conscious) sedation Codes for surgery: 10021–69990[edit] (10021–10022) general (10040–19499) integumentary system (20000–29999) musculoskeletal system (30000–32999) respiratory system (33010–37799) cardiovascular system (38100–38999) hemic and lymphatic systems (39000–39599) mediastinum and diaphragm (40490–49999) digestive system (50010–53899) urinary system (54000–55899) male genital system (55920–55980) reproductive system and intersex (56405–58999) female genital system (59000–59899) maternity care and delivery (60000–60699) endocrine system (61000–64999) nervous system (65091–68899) eye and ocular adnexa (69000–69979) auditory system Codes for Radiology: 70010-79999[edit] (70010–76499) diagnostic imaging (76506–76999) diagnostic ultrasound (77001–77032) radiologic guidance (77051–77059) breast mammography (77071–77084) bone/joint studies (77261–77799) radiation oncology (78000–79999) nuclear medicine Codes for pathology and laboratory: 80047–89398[edit] (80047–80076) organ or disease-oriented panels (80100–80103) drug testing (80150–80299) therapeutic drug assays (80400–80440) evocative/suppression testing (80500–80502) consultations (clinical pathology) (81000–81099) urinalysis (82000–84999) chemistry (85002–85999) hematology and coagulation (86000–86849) immunology (86850–86999) transfusion medicine (87001–87999) microbiology (88000–88099) anatomic pathology (postmortem) (88104–88199) cytopathology (88230–88299) cytogenetic studies (88300–88399) surgical pathology (88720–88741) in vivo (transcutaneous) lab procedures (89049–89240) other procedures (89250–89398) reproductive medicine procedures Codes for medicine: 90281–99099; 99151–99199; 99500–99607[edit] (90281–90399) immune globulins, serum or recombinant prods (90465–90474) immunization administration for vaccines/toxoids (90476–90749) vaccines, toxoids (90801–90899) psychiatry (90901–90911) biofeedback (90935–90999) dialysis (91000–91299) gastroenterology (92002–92499) ophthalmology (92502–92700) special otorhinolaryngologic services (92950–93799) cardiovascular (93875–93990) noninvasive vascular diagnostic studies (94002–94799) pulmonary (95004–95199) allergy and clinical immunology (95250–95251) endocrinology (95803–96020) neurology and neuromuscular procedures (96101–96125) central nervous system assessments/tests (neuro-cognitive, mental status, speech testing) (96150–96155) health and behavior assessment/intervention (96360–96549) hydration, therapeutic, prophylactic, diagnostic injections and infusions, and chemotherapy and other highly complex drug or highly complex biologic agent administration (96567–96571) photodynamic therapy (96900–96999) special dermatological procedures (97001–97799) physical medicine and rehabilitation (97802–97804) medical nutrition therapy (97810–97814) acupuncture (98925–98929) osteopathic manipulative treatment (98940–98943) chiropractic manipulative treatment (98960–98962) education and training for patient self-management (98966–98969) non-face-to-face nonphysician services (99000–99091) special services, procedures and reports (99170–99199) other services and procedures (99500–99602) home health procedures/services (99605–99607) medication therapy management services Category II[edit] Category II codes are reviewed by the Performance Measures Advisory Group (PMAG), an advisory body to the CPT Editorial Panel and the CPT/HCPAC Advisory Committee. The PMAG is composed of performance measurement experts representing the Agency for Healthcare Research and Quality (AHRQ), the American Medical Association (AMA), the Centers for Medicare and Medicaid Services (CMS), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the National Committee for Quality Assurance (NCQA) and the Physician Consortium for Performance Improvement. The PMAG may seek additional expertise and/or input from other national health care organizations, as necessary, for the development of Category II codes. These may include national medical specialty societies, other national health care professional associations, accrediting bodies and federal regulatory agencies. Category II codes make use of an alphabetical character as the 5th character in the string (i.e., 4 digits followed by the letter F). These digits are not intended to reflect the placement of the code in the regular (Category I) part of the CPT codebook. Appendix H in CPT section contains information about performance measurement exclusion of modifiers, measures, and the measures' source(s). Currently there are 11 Category II codes. They are: (0001F-0015F) Composite measures (0500F-0575F) Patient management (1000F-1220F) Patient history (2000F-2050F) Physical examination (3006F-3573F) Diagnostic/screening processes or results (4000F-4306F) Therapeutic, preventive or other interventions (5005F-5100F) Follow-up or other outcomes (6005F-6045F) Patient safety (7010F-7025F) Structural Measures CPT II codes are billed in the procedure code field, just as CPT Category I codes are billed. CPT II codes describe clinical components usually included in evaluation and management or clinical services and are not associated with any relative value. Therefore, CPT II codes are billed with a $0.00 billable charge amount.[8] Category III[edit] Category III CPT Code(s) – Emerging technology (Category III codes: 0016T-0207T[9]) Major psychotherapy revisions[edit] The CPT code revisions that affect counselors are simple and straightforward. Here is a list of psychotherapy CPT codes that will be retired, and their 2013 comparables: 90801 –> \ Family therapy codes (90847 and 90846) will remain unchanged, as will codes for psychological testing.[10] Copyright[edit] CPT is a registered trademark of the American Medical Association. The AMA holds the copyright for the CPT coding system.[11] This was upheld in Practice Management v. American Medical Association. Despite the copyrighted nature of the CPT code sets, the use of the code is mandated by almost all health insurance payment and information systems, including the Centers for Medicare and Medicaid Services (CMS) and HIPAA, and the data for the code sets appears in the Federal Register. As a result, it is necessary for most users of the CPT code (principally providers of services) to pay license fees for access to the code.[12] Limited CPT search offered by the AMA[edit] The AMA offers a limited search of the CPT manual for personal, non-commercial use on its web site.[13] See also[edit] Medical classification Procedure code ICD-9 ICD-10-PCS HCPCS Specialty Society Relative Value Scale Update Committee External links[edit] Official site by the AMA Description of the three sections[dead link] from the AMA CPT® Process – How a Code Becomes a Code from the AMA QandA[dead link] from the American Academy of Family Physicians [hide] v t e Medical classification Topographical codes TA TH TE SNOMED T axis MeSH A axis Diagnostic codes general: ICD-10 ICD-9 ICPC-2 NANDA Read codes SNOMED D axis specialized: ICD-O ICSD ICHD ILDS DSM-IV BPA Procedural codes HCPCS (CPT, Level 2) ICD-10 PCS ICD-9-CM Volume 3 NIC SNOMED P axis OPS-301 Read codes/OPCS-4 CCAM ICHI LOINC Pharmaceutical codes ATC NDC SNOMED C axis DIN Outcomes codes NOC Categories: Medical manuals American Medical Association --------------------- SOME GENERAL INFO ABOUT Medical classification From Wikipedia, the free encyclopedia (Redirected from Medical coding) Medical classification, or medical coding, is the process of transforming descriptions of medical diagnoses and procedures into universal medical code numbers. The diagnoses and procedures are usually taken from a variety of sources within the health care record, such as the transcription of the physician's notes, laboratory results, radiologic results, and other sources. Diagnosis codes are used to track diseases and other health conditions, inclusive of chronic diseases such as diabetes mellitus and heart disease, and contagious diseases such as norovirus, the flu, and athlete's foot. These diagnosis and procedure codes are used by government health programs, private health insurance companies, workers' compensation carriers and others. Medical classification systems are used for a variety of applications in medicine, public health and medical informatics, including: statistical analysis of diseases and therapeutic actions reimbursement; e.g., based on diagnosis-related groups knowledge-based and decision support systems direct surveillance of epidemic or pandemic outbreaks There are country specific standards and international classification systems. Contents [hide] 1 Classification types 2 WHO Family of International Classifications 2.1 Reference classifications 2.2 Derived classifications 2.3 Related classifications 3 Other medical classifications 3.1 Diagnosis 3.2 Procedure 3.3 Other 3.3.1 Library classification that have medical components 4 ICD, SNOMED and Electronic Health Record (EHR) 4.1 What is SNOMED? 4.2 What is ICD? 4.3 SNOMED CT vs ICD 4.4 Data Mapping of SNOMED and ICD 5 Clinical Coding in Australia 5.1 What is clinical coding? 5.2 What does clinical coder do? 5.3 What is coded data used for? 6 See also 7 References 8 External links Classification types[edit] Many different medical classifications exist, though they occur into two main groupings: Statistical classifications and Nomenclatures. A statistical classification brings together similar clinical concepts and groups them into categories. The number of categories is limited so that the classification does not become too big. An example of this is used by the International Statistical Classification of Diseases and Related Health Problems (known as ICD). ICD groups diseases of the circulatory system into one "chapter," known as Chapter IX, covering codes I00–I99. One of the codes in this chapter (I47.1) has the code title (rubric) Supraventricular tachycardia. However, there are several other clinical concepts that are also classified here. Among them are paroxysmal atrial tachycardia, paroxysmal junctional tachycardia, auricular tachycardia and nodal tachycardia. Another feature of statistical classifications is the provision of residual categories for "other" and "unspecified" conditions that do not have a specific category in the particular classification. In a nomenclature there is a separate listing and code for every clinical concept. So, in the previous example, each of the tachycardia listed would have its own code. This makes nomenclatures unwieldy for compiling health statistics. Types of coding systems specific to health care include: Diagnostic codes -Are used to determine diseases, disorders, and symptoms -Can be used to measure morbidity and mortality Examples: ICD-9-CM, ICD-10 Procedural codes -They are numbers or alphanumeric codes used to identify specific health interventions taken by medical professionals. Examples: ICPM, ICHI Pharmaceutical codes -Are used to identify medications Examples: AT, NDC Topographical codes -Are codes that indicate a specific location in the body Examples :ICD-O, SNOMED WHO Family of International Classifications[edit] The World Health Organization (WHO) maintains several internationally endorsed classifications designed to facilitate the comparison of health related data within and across populations and over time as well as the compilation of nationally consistent data.[1] This "Family of International Classifications" (FIC) include three main (or reference) classifications on basic parameters of health prepared by the organization and approved by the World Health Assembly for international use, as well as a number of derived and related classifications providing additional details. Some of these international standards have been revised and adapted by various countries for national use. Reference classifications[edit] International Statistical Classification of Diseases and Related Health Problems (ICD)[2] ICD-9 (9th revision, published in 1977) ICD-9-CM (Clinical Modification, used in the US) ICD-10 (10th revision, in use by WHO since 1994) ICD-10-CM (Clinical Modification, used in the US) ICD-10-PCS (Procedure Coding System, used in the US) ICD-10-CA (used for morbidity classification in Canada).[3] ICD-10-AM (used in Australia and New Zealand)[4] EUROCAT - an extension of the ICD-10 Q chapter for congenital disorders International Classification of Functioning, Disability and Health (ICF) International Classification of Health Interventions (ICHI) (previously known as International Classification of Procedures in Medicine)[5] Derived classifications[edit] Derived classifications are based on the WHO reference classifications (i.e. ICD and ICF).[1] They include the following: International Classification of Diseases for Oncology, Third Edition (ICD-O-3) ICD-10 for Mental and Behavioural Disorders[6] Application of the International Classification of Diseases to Dentistry and Stomatology, 3rd Edition (ICD-DA)[7] Application of the International Classification of Diseases to Neurology (ICD-10-NA)[8] Related classifications[edit] Related classifications in the WHO-FIC are those that partially refer to the reference classifications, e.g. only at specific levels.[1] They include: International Classification of Primary Care (ICPC)[9] ICPC-2 PLUS International Classification of External Causes of Injury (ICECI)[10] Anatomical Therapeutic Chemical Classification System with Defined Daily Doses (ATC/DDD) Technical aids for persons with disabilities: Classification and terminology (ISO9999)[11] International Classification for Nursing Practice (ICNP)[12] Other medical classifications[edit] Diagnosis[edit] The categories in a diagnosis classification classify [ and medical signs. In addition to the ICD and its national variants, they include: Diagnostic and Statistical Manual of Mental Disorders (DSM) DSM-IV Codes International Classification of Headache Disorders 2nd Edition (ICHD-II)[13] International Classification of Sleep Disorders (ICSD) Online Mendelian Inheritance in Man, database of genetic codes Read codes Systematized Nomenclature of Medicine - Clinical Terms (SNoMed-CT) Procedure[edit] The categories in a procedure classification classify specific health interventions undertaken by health professionals. In addition to the ICHI and ICPC, they include: Australian Classification of Health Interventions (ACHI) Canadian Classification of Health Interventions (CCI)[14] Chinese Classification of Heath Interventions (CCHI) Current Procedural Terminology (CPT) Health Care Procedure Coding System (HCPCS) ICD-10 Procedure Coding System (ICD-10-PCS) Office of Population, Censuses and Surveys Classification of Surgical Operations and Procedures (OPCS-4) Other[edit] Classification of Pharmaco-Therapeutic Referrals (CPR) Logical Observation Identifiers Names and Codes (LOINC), standard for identifying medical laboratory observations Medical Dictionary for Regulatory Activities (MedDRA) Medical Subject Headings (MeSH) List of MeSH codes Nursing Interventions Classification (NIC) Nursing Outcomes Classification (NOC) TIME-ITEM, ontology of topics in medical education TNM Classification of Malignant Tumors Unified Medical Language System (UMLS) Victoria Ambulatory Coding System (VACS) / Queensland Ambulatory Coding System (QACS), Australia[citation needed] Library classification that have medical components[edit] Dewey Decimal System and Universal Decimal Classification (section 610–620) National Library of Medicine classification ICD, SNOMED and Electronic Health Record (EHR)[edit] What is SNOMED?[edit] The Systematized Nomenclature of Medicine (SNOMED) is the most widely recognised nomenclature in healthcare.[15] Its current version, SNOMED Clinical Terms (SNOMED CT), is intended to provide a set of concepts and relationships that offers a common reference point for comparison and aggregation of data about the health care process.[16] SNOMED CT is often described as a reference terminology.[17] SNOMED CT contains more than 311,000 active concepts with unique meanings and formal logic-based definitions organised into hierarchies.[16] SNOMED CT can be used by anyone with an Affiliate License, 40 low income countries defined by the World Bank or qualifying research, humanitarian and charitable projects.[16] SNOMED-CT is designed to be managed by computer, and it is a complex relationship concepts.[15] What is ICD?[edit] The International Classification of Disease (ICD) is the most widely recognized medical classification maintained by the World Health Organization (WHO).[18] Its primary purpose is to categorise diseases for morbidity and mortality reporting. The United States has used a clinical modification of ICD (ICD-9-CM) for the additional purposes of reimbursement. ICD-10 was endorsed by WHO in 1990, and WHO Member states began using the classification system in 1994 for both morbidity and mortality reporting. In the US, however, it has only been used for reporting mortality since 1999. Because of the US delay in adopting its version of ICD-10, it is currently unable to compare morbidity data with the rest of the world. ICD has a hierarchical structure, and coding in this context, is the term applied when representations are assigned to the words they represent.[18] Coding diagnoses and procedures is the assignment of codes from a code set that follows the rules of the underlying classification or other coding guidelines. SNOMED CT vs ICD[edit] SNOMED CT and ICD are designed for different purposes and each should each be used for the purposes for which it was designed.[19] As a core terminology for the EHR, SNOMED CT provides a common language that enables a consistent language that enables a consistent way of capturing, sharing, and aggregating health data across specialties and sites of care.[20] It is highly detailed terminology designed for input not reporting. Classification systems such as ICD-9-CM, ICD-10-CM, and ICD-10-PCS group together similar diseases and procedures and organise related entities for easy retrieval.[20] They are typically used for external reporting requirements or other uses where data aggregation is advantageous, such as measuring the quality of care monitoring resource utilisation, or processing claims for reimbursement. SNOMED is clinically-based, document whatever is needed for patient care and has better clinical coverage than ICD. ICD’s focus is statistical with less common diseases get lumped together in “catch-all” categories, which result in loss of information. SNOMED CT is used directly by healthcare providers during the process of care, whereas ICD is used by coding professionals after the episode of care. SNOMED CT had multiple hierarchy, whereas single hierarchy for ICD. SNOMED CT concepts are defined logically by their attributes, whereas only textual rules and definitions in ICD.[20] Data Mapping of SNOMED and ICD[edit] SNOMED and ICD can be coordinated. The National Library of Medicine (NLM) maps ICD-9-CM, ICD-10-CM, ICD-10-PCS, and other classification systems to SNOMED.[21] Data Mapping is the process of identifying relationships between two distinct data models. The full value of the health information contained in an EHR system will only be realised if both systems involved in the map are up to date and accurately reflect the current practice of medicine.[18] Clinical Coding in Australia[edit] Medical coding and classification systems are expected to become increasingly important in the health care sector. Together with and as an integrated part of the electronic health information systems, the coding and classification systems will be used to improve the quality and effectiveness of the medical services.[22] What is clinical coding?[edit] Clinical coding is the translation of written, scanned and/or electronic clinical documentation about patient care into code format. For example, hypertension is represented by the code 'I10'; general anaethesia is represented by the code'92514-XX[1910]'. A standardised classification system, The International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM), is applied in all Australian acute health facilities. It is based on the World Health Organisation (WHO) ICD-10 system, updated with the Australian Classification of Health Interventions (ACHI), Australian Coding Standards (ACS). Clinical coding is a specialised skill requiring excellent knowledge of medical terminology and disease processes, attention to detail, and analytical skills.[23] What does clinical coder do?[edit] A clinical coder is responsible for abstracting relevant information from the medical record and deciding which diagnoses and procedures meet criteria for coding as per Australian and State Coding Standards. The coder then assigns codes for these diagnoses and procedures based on ICD-10-AM conventions and standards.[23] What is coded data used for?[edit] The assigned codes and other patient data are processed by grouper software to determine a diagnosis-related group (DRG) for the episode of care, which is used for funding and reimbursement. This process allows hospital episodes to be grouped into meaningful categories, helping us to better match patient needs to health care resources.[24] See also[edit] Acronyms in healthcare Ambulatory Payment Classification, US billing system for outpatient services Biological database Classification of mental disorders Clinical coder German Institute for Medical Documentation and Information Health information management Health informatics Human resources for health information system List of international common standards Medical dictionary North American Nursing Diagnosis Association (professional organization) Nosology External links[edit] WHO Family of International Classifications official site Medical terminologies at the National Library of Medicine [show] v t e Medical classification [hide] v t e Health informatics Health information management Electronic health record Personal health record Clinic management system Hospital information system DICOM Health information technology Regional Health Information Organization Computerized physician order entry subdisciplines Bioinformatics Translational medicine Computational biology Public health informatics Medical classification ICD LOINC HRHIS Continuity of Care Record ISO 27799 Professional organizations International Medical Informatics Association Australasian College of Health Informatics Brazilian Society of Health Informatics Indian Association for Medical Informatics American Medical Informatics Association European Federation for Medical Informatics other concepts Health Level 7 List of medical and health informatics journals Categories: Medical classification Nursing classification ------------------------ SOME GENERAL INFO ABOUT Medical diagnosis From Wikipedia, the free encyclopedia Radiography is an important tool in diagnosis of certain disorders. Medical diagnosis (often abbreviated dx or Dx) is diagnosis in the field of medicine, that is, the determination of which disease or condition is causing a person's signs and symptoms. It is called simply diagnosis when the medical context is implicit. Both the process of determining which disease or condition is present and the conclusion that is reached by this process are called "diagnosis" (for example, the process of diagnosis can yield a diagnosis of strep throat). The foundation of diagnosis is always the information from the history and the physical examination, but often one or more diagnostic procedures, such as diagnostic tests, are also done during the process. Diagnosis is often challenging, because many signs and symptoms are nonspecific. For example, redness of the skin (erythema), by itself, is a sign of many disorders and thus doesn't tell the physician what is wrong. Thus differential diagnosis, in which several possible explanations are compared and contrasted, must be performed. This involves the correlation of various pieces of information followed by the recognition and differentiation of patterns. Occasionally the process is made easy by a sign or symptom (or a group of several) that is pathognomonic. Diagnosis is a major component of the procedure of a doctor's visit. From the point of view of statistics, the diagnostic procedure involves classification tests. Contents [hide] 1 History and etymology 1.1 Diagnostic procedures 1.2 Diagnostic opinion 2 Indication for diagnostic procedure 3 General components 4 Specific methods 4.1 Differential diagnosis 4.2 Pattern recognition 4.3 Diagnostic criteria 4.4 Clinical decision support system 4.5 Other diagnostic procedure methods 5 Diagnostic opinion and its effects 6 Additional types of diagnosis 7 Overdiagnosis 8 Errors 9 Lag time 10 See also 10.1 Lists 11 References 12 External links History and etymology[edit] Main article: History of medical diagnosis The history of medical diagnosis began in earnest from the days of Imhotep in ancient Egypt and Hippocrates in ancient Greece. In Traditional Chinese Medicine, there are four diagnostic methods: inspection, auscultation-olfaction, interrogation, and palpation.[1] A Babylonian medical textbook, the Diagnostic Handbook written by Esagil-kin-apli (fl. 1069-1046 BC), introduced the use of empiricism, logic and rationality in the diagnosis of an illness or disease.[2] The book made use of logical rules in combining observed symptoms on the body of a patient with its diagnosis and prognosis.[3] Esagil-kin-apli described the symptoms for many varieties of epilepsy and related ailments along with their diagnosis and prognosis.[4] The plural of diagnosis is diagnoses, the verb is to diagnose, and a person who diagnoses is called a diagnostician. The word diagnosis /da?.?g'no?s?s/ is derived through Latin from the Greek word d?a?????s?e?, meaning to discern or distinguish.[5] The practice of diagnosis continues to be dominated by theories set down in the early 20th century.[citation needed] Medical diagnosis or the actual process of making a diagnosis is a cognitive process. A clinician uses several sources of data and puts the pieces of the puzzle together to make a diagnostic impression. The initial diagnostic impression can be a broad term describing a category of diseases instead of a specific disease or condition. After the initial diagnostic impression, the clinician obtains follow up tests and procedures to get more data to support or reject the original diagnosis and will attempt to narrow it down to a more specific level. Diagnostic procedures are the specific tools that the clinicians use to narrow the diagnostic possibilities. Diagnostic procedures[edit] A diagnosis, in the sense of diagnostic procedure, can be regarded as an attempt at classification of an individual's condition into separate and distinct categories that allow medical decisions about treatment and prognosis to be made. Subsequently, a diagnostic opinion is often described in terms of a disease or other condition, but in the case of a wrong diagnosis, the individual's actual disease or condition is not the same as the individual's diagnosis. A diagnostic procedure may be performed by various health care professionals such as a physician, physical therapist, optometrist, healthcare scientist, chiropractor, dentist, podiatrist, nurse practitioner, or physician assistant. This article uses diagnostician as any of these person categories. A diagnostic procedure (as well as the opinion reached thereby) does not necessarily involve elucidation of the etiology of the diseases or conditions of interest, that is, what caused the disease or condition. Such elucidation can be useful to optimize treatment, further specify the prognosis or prevent recurrence of the disease or condition in the future. Diagnostic opinion[edit] However, a diagnosis can take many forms.[6] It might be a matter of naming the disease, lesion, dysfunction or disability. It might be a management-naming or prognosis-naming exercise. It may indicate either degree of abnormality on a continuum or kind of abnormality in a classification. It’s influenced by non-medical factors such as power, ethics and financial incentives for patient or doctor. It can be a brief summation or an extensive formulation, even taking the form of a story or metaphor. It might be a means of communication such as a computer code through which it triggers payment, prescription, notification, information or advice. It might be pathogenic or salutogenic. It’s generally uncertain and provisional. Indication for diagnostic procedure[edit] The initial task is to detect a medical indication to perform a diagnostic procedure. Indications include: Detection of any deviation from what is known to be normal, such as can be described in terms of, for example, anatomy (the structure of the human body), physiology (how the body works), pathology (what can go wrong with the anatomy and physiology), psychology (thought and behavior) and human homeostasis (regarding mechanisms to keep body systems in balance). Knowledge of what is normal and measuring of the patient's current condition against those norms can assist in determining the patient's particular departure from homeostasis and the degree of departure, which in turn can assist in quantifying the indication for further diagnostic processing. A complaint expressed by a patient. The fact that a patient has sought a diagnostician can itself be an indication to perform a diagnostic procedure. Therefore, in, for example, a doctor's visit, the physician may already start performing a diagnostic procedure by, for example, watching the gait of the patient from the waiting room to the doctor's office even before she or he has started to present any complaints. Even during an already ongoing diagnostic procedure, there can be an indication to perform another, separate, diagnostic procedure for another, potentially concomitant, disease or condition. This may occur as a result of an incidental finding of a sign unrelated to the parameter of interest, such as can occur in comprehensive tests such as radiological studies like magnetic resonance imaging or blood test panels that also include blood tests that are not relevant for the ongoing diagnosis. General components[edit] General components, which are present in a diagnostic procedure in most of the various available methods include: Complementing the already given information with further data gathering, which may include questions of the medical history (potentially from other people close to the patient as well), physical examination and various diagnostic tests. A diagnostic test is any kind of medical test performed to aid in the diagnosis or detection of disease. Diagnostic tests can also be used to provide prognostic information on people with established disease.[7] Processing of the answers, findings or other results. Consultations with other providers and specialists in the field may be sought. Specific methods[edit] There are a number of methods or techniques that can be used in a diagnostic procedure, including performing a differential diagnosis or following medical algorithms.[8] In reality, a diagnostic procedure may involve components of multiple methods.[9] Differential diagnosis[edit] Main article: Differential diagnosis The method of differential diagnosis is based on finding as many candidate diseases or conditions as possible that can possibly cause the signs or symptoms, followed by a process of elimination or at least of rendering the entries more or less probable by further medical tests and other processing until, aiming to reach the point where only one candidate disease or condition remains as probable. The final result may also remain a list of possible conditions, ranked in order of probability or severity. The resultant diagnostic opinion by this method can be regarded more or less as a diagnosis of exclusion. Even if it doesn't result in a single probable disease or condition, it can at least rule out any imminently life-threatening conditions. Unless the provider is certain of the condition present, further medical tests, such as medical imaging, are performed or scheduled in part to confirm or disprove the diagnosis but also to document the patient's status and keep the patient's medical history up to date. If unexpected findings are made during this process, the initial hypothesis may be ruled out and the provider must then consider other hypotheses. Pattern recognition[edit] In a pattern recognition method the provider uses experience to recognize a pattern of clinical characteristics.[8] It is mainly based on certain symptoms or signs being associated with certain diseases or conditions, not necessarily involving the more cognitive processing involved in a differential diagnosis. This may be the primary method used in cases where diseases are "obvious", or the provider's experience may enable him or her to recognize the condition quickly. Theoretically, a certain pattern of signs or symptoms can be directly associated with a certain therapy, even without a definite decision regarding what is the actual disease, but such a compromise carries a substantial risk of missing a diagnosis which actually has a different therapy so it may be limited to cases where no diagnosis can be made. Diagnostic criteria[edit] The term diagnostic criteria designates the specific combination of signs, symptoms, and test results that the clinician uses to attempt to determine the correct diagnosis. Some examples of diagnostic criteria are: Amsterdam criteria for hereditary nonpolyposis colorectal cancer McDonald criteria for multiple sclerosis ACR criteria for systemic lupus erythematosus Centor criteria for strep throat Clinical decision support system[edit] Clinical decision support systems are interactive computer programs designed to assist health professionals with decision-making tasks. The clinician interacts with the software utilizing both the clinician’s knowledge and the software to make a better analysis of the patients data than either human or software could make on their own. Typically the system makes suggestions for the clinician to look through and the clinician picks useful information and removes erroneous suggestions.[10] Other diagnostic procedure methods[edit] Other methods that can be used in performing a diagnostic procedure include: An example of a medical algorithm for assessment and treatment of overweight and obesity. Usage of medical algorithms An "exhaustive method", in which every possible question is asked and all possible data is collected.[8] Use of a sensory pill that collects and transmits physiological information after being swallowed.[11] Using optical coherence tomography to produce detailed images of the brain or other soft tissue, through a "window" made of zirconia that has been modified to be transparent and implanted in the skull.[12] Diagnostic opinion and its effects[edit] Once a diagnostic opinion has been reached, the provider is able to propose a management plan, which will include treatment as well as plans for follow-up. From this point on, in addition to treating the patient's condition, the provider can educate the patient about the etiology, progression, prognosis, other outcomes, and possible treatments of her or his ailments, as well as providing advice for maintaining health. A treatment plan is proposed which may include therapy and follow-up consultations and tests to monitor the condition and the progress of the treatment, if needed, usually according to the medical guidelines provided by the medical field on the treatment of the particular illness. Relevant information should be added to the medical record of the patient. A failure to respond to treatments that would normally work may indicate a need for review of the diagnosis. Additional types of diagnosis[edit] Sub-types of diagnoses include: Clinical diagnosis A diagnosis made on the basis of medical signs and patient-reported symptoms, rather than diagnostic tests Laboratory diagnosis A diagnosis based significantly on laboratory reports or test results, rather than the physical examination of the patient. For instance, a proper diagnosis of infectious diseases usually requires both an examination of signs and symptoms, as well as laboratory characteristics of the pathogen involved. Radiology diagnosis A diagnosis based primarily on the results from medical imaging studies. Greenstick fractures are common radiological diagnoses. Principal diagnosis The single medical diagnosis that is most relevant to the patient's chief complaint or need for treatment. Many patients have additional diagnoses. Admitting diagnosis The diagnosis given as the reason why the patient was admitted to the hospital; it may differ from the actual problem or from the discharge diagnoses, which are the diagnoses recorded when the patient is discharged from the hospital. Differential diagnosis A process of identifying all of the possible diagnoses that could be connected to the signs, symptoms, and lab findings, and then ruling out diagnoses until a final determination can be made. Diagnostic criteria Designates the combination of signs, symptoms, and test results that the clinician uses to attempt to determine the correct diagnosis. They are standards, normally published by international committees, and they are designed to offer the best sensitivity and specificity possible, respect the presence of a condition, with the state-of-the-art technology. Prenatal diagnosis Diagnosis work done before birth Diagnosis of exclusion A medical condition whose presence cannot be established with complete confidence from either examination or testing. Diagnosis is therefore by elimination of all other reasonable possibilities. Dual diagnosis The diagnosis of two related, but separate, medical conditions or co-morbidities; the term almost always refers to a diagnosis of a serious mental illness and a substance addiction. Self-diagnosis The diagnosis or identification of a medical conditions in oneself. Self-diagnosis is very common and typically accurate for everyday conditions, such as headaches, menstrual cramps, and headlice. Remote diagnosis A type of telemedicine that diagnosis a patient without being physically in the same room as the patient. Nursing diagnosis Rather than focusing on biological processes, a nursing diagnosis identifies people's responses to situations in their lives, such as a readiness to change or a willingness to accept assistance. Computer-aided diagnosis Providing symptoms allows the computer to identify the problem and diagnose the user to the best of its ability. Health screening begins by identifying the part of the body where the symptoms are located; the computer cross-references a database for the corresponding disease and presents a diagnosis.[13] Overdiagnosis The diagnosis of "disease" that will never cause symptoms, distress, or death during a patient's lifetime Wastebasket diagnosis A vague, or even completely fake, medical or psychiatric label given to the patient or to the medical records department for essentially non-medical reasons, such as to reassure the patient by providing an official-sounding label, to make the provider look effective, or to obtain approval for treatment. This term is also used as a derogatory label for disputed, poorly described, overused, or questionably classified diagnoses, such as pouchitis and senility, or to dismiss diagnoses that amount to overmedicalization, such as the labeling of normal responses to physical hunger as reactive hypoglycemia. Retrospective diagnosis The labeling of an illness in a historical figure or specific historical event using modern knowledge, methods and disease classifications. Overdiagnosis[edit] Main article: Overdiagnosis Overdiagnosis is the diagnosis of "disease" that will never cause symptoms or death during a patient's lifetime. It is a problem because it turns people into patients unnecessarily and because it can lead to economic waste (overutilization) and treatments that may cause harm. Overdiagnosis occurs when a disease is diagnosed correctly, but the diagnosis is irrelevant. A correct diagnosis may be irrelevant because treatment for the disease is not available, not needed, or not wanted. Errors[edit] Further information: Medical error Causes and factors of error in diagnosis are:[14] the manifestation of disease are not sufficiently noticeable a disease is omitted from consideration too much significance is given to some aspect of the diagnosis the condition is a rare disease with symptoms suggestive of many other conditions the condition has a rare presentation Lag time[edit] When making a medical diagnosis, a lag time is a delay in time until a step towards diagnosis of a disease or condition is made. Types of lag times are mainly: Onset-to-medical encounter lag time, the time from onset of symptoms until visiting a health care provider[15] Encounter-to-diagnosis lag time, the time from first medical encounter to diagnosis[15] See also[edit] Diagnosis codes Diagnosis-related group Diagnostic and Statistical Manual of Mental Disorders Doctor-patient relationship Etiology (medicine) International Statistical Classification of Diseases and Related Health Problems (ICD) Medical classification Merck Manual of Diagnosis and Therapy Misdiagnosis and medical error Nosology Nursing diagnosis Pathogenesis Pathology Preimplantation genetic diagnosis Lists[edit] List of diagnostic classification and rating scales used in psychiatry List of diseases List of disorders List of medical symptoms Category:Diseases External links[edit] Look up diagnosis in Wiktionary, the free dictionary. How A Diagnosis Works [show] v t e Basic medical terms used to describe disease conditions [show] v t e Medical examination and history taking [show] v t e Health care Categories: Medical diagnosis Medical terminology Nosology Advanced practice registered nursing --------------------- SOME GENERAL INFO ABOUT Nosology From Wikipedia, the free encyclopedia This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (January 2010) Nosology (from Ancient Greek ??s?? (nosos), meaning "disease", and -????a (-logia), meaning "study of-") is a branch of medicine that deals with classification of diseases. Contents [hide] 1 Types of classification 2 History 3 Applications 4 See also 5 References 6 External links Types of classification[edit] Diseases may be classified by etiology (cause), pathogenesis (mechanism by which the disease is caused), or by symptom(s). Alternatively, diseases may be classified according to the organ system involved, though this is often complicated since many diseases affect more than one organ. A chief difficulty in nosology is that diseases often cannot be defined and classified clearly, especially when etiology or pathogenesis are unknown. Thus diagnostic terms often only reflect a symptom or set of symptoms (syndrome). Disease is not a fixed entity but an ever changing process like that of life itself. Disease is an abstraction made by our mental concept;the factual reality is the diseased person. Must read Classification of disease by Dr. Samuel Hahnemann (Father of Homeopathy) History[edit] The Ayurveda is a collection of early Indian works about medicine. In China the Huangdi Neijing is another ancient text. In the West, Hippocrates was one of the earliest writers on the subject of disease. The book of Leviticus also includes an early discussion of the treatment of skin diseases. See Metzora (parsha) In the 10th century the Arabian psychologist Najab ud-din Unhammad classified a nosology of nine major categories of mental disorders, which included 30 different mental illnesses in total. Some of the categories he described included obsessive-compulsive disorders, delusional disorders, degenerative diseases, involutional melancholia, and states of abnormal excitement.[1][verification needed] In the 18th century, the taxonomist Carolus Linnaeus, Francois Boissier de Sauvages, and psychiatrist Philippe Pinel developed an early classification of physical illnesses. Thomas Sydenham's work in the late 17th century might also be considered a nosology. In the 19th century, Emil Kraepelin and then Jacques Bertillon developed their own nosologies. Bertillon's work, classifying causes of death, was a precursor of the modern code system, the International Classification of Diseases. The early nosological efforts grouped diseases by their symptoms, whereas modern systems (e.g. SNOMED) focus on grouping diseases by the anatomy and etiology involved. Applications[edit] Nosology is used extensively in public health, to allow epidemiological studies of public health issues. Analysis of death certificates requires nosological coding of causes of death. Nosological classifications are used in medical administration, such as filing of health insurance claims, and patient records, among others See also[edit] Clinical coder Differential diagnosis International Statistical Classification of Diseases and Related Health Problems (ICD) ICD-10 (ICD 10th Revision) Medical classification Pathology (study of disease) Category:Diseases and disorders (Wikipedia's categorization of diseases) References[edit] Jump up ^ Millon, Theodore (2004), Masters of the Mind: Exploring the Story of Mental Illness from Ancient Times to the New Millennium, John Wiley & Sons, p. 38, ISBN 978-0-471-46985-8 External links[edit] Gordon L. Snider, Nosology for Our Day Its Application to Chronic Obstructive Pulmonary Disease, American Journal of Respiratory and Critical Care Medicine Vol 167. pp. 678–683, (2003). fulltext C. S. Herrman, The Bipolar Spectrum, SSRN (Social Science Research Network, 5 August 2010) [1] Nosology.net: An online resource for nosologic diagnostic systems. This site also demonstrates how the proposed system can be used currently in Neurology and Psychiatry International Classification of Diseases by the World Health Organization. [2] Categories: Medical terminology Nosology --------------------- SOME GENERAL INFO ABOUT Experiment From Wikipedia, the free encyclopedia (Redirected from Laboratory Tests) "Experimental" redirects here. For the musical classification, see Experimental music. For other uses, see Experiment (disambiguation). Even very young children perform rudimentary experiments in order to learn about the world. An experiment is an orderly procedure carried out with the goal of verifying, refuting, or establishing the validity of a hypothesis. Controlled experiments provide insight into cause-and-effect by demonstrating what outcome occurs when a particular factor is manipulated. Controlled experiments vary greatly in their goal and scale, but always rely on repeatable procedure and logical analysis of the results. There also exist natural experimental studies. A child may carry out basic experiments to understand the nature of gravity, while teams of scientists may take years of systematic investigation to advance the understanding of a phenomenon. Experiments can vary from personal and informal natural comparisons (e.g. tasting a range of chocolates to find a favorite), to highly controlled (e.g. tests requiring complex apparatus overseen by many scientists that hope to discover information about subatomic particles). Uses of experiments vary considerably between the natural and human sciences. Contents [hide] 1 Overview 2 History 3 Types of experiment 3.1 Controlled experiments 3.2 Natural experiments 3.3 Field experiments 4 Contrast with observational study 5 Ethics 6 Experimental method in Law 7 See also 8 Notes 9 Further reading 10 External links Overview[edit] In the scientific method, an experiment is an empirical method that arbitrates between competing models or hypotheses.[1][2] Experimentation is also used to test existing theories or new hypotheses in order to support them or disprove them.[3][4] An experiment usually tests a hypothesis, which is an expectation about how a particular process or phenomenon works. However, an experiment may also aim to answer a "what-if" question, without a specific expectation about what the experiment will reveal, or to confirm prior results. If an experiment is carefully conducted, the results usually either support or disprove the hypothesis. According to some Philosophies of science, an experiment can never "prove" a hypothesis, it can only add support. Similarly, an experiment that provides a counterexample can disprove a theory or hypothesis. An experiment must also control the possible confounding factors—any factors that would mar the accuracy or repeatability of the experiment or the ability to interpret the results. Confounding is commonly eliminated through scientific control and/or, in randomized experiments, through random assignment. In engineering and other physical sciences, experiments are a primary component of the scientific method. They are used to test theories and hypotheses about how physical processes work under particular conditions (e.g., whether a particular engineering process can produce a desired chemical compound). Typically, experiments in these fields will focus on replication of identical procedures in hopes of producing identical results in each replication. Random assignment is uncommon. In medicine and the social sciences, the prevalence of experimental research varies widely across disciplines. When used, however, experiments typically follow the form of the clinical trial, where experimental units (usually individual human beings) are randomly assigned to a treatment or control condition where one or more outcomes are assessed.[5] In contrast to norms in the physical sciences, the focus is typically on the average treatment effect (the difference in outcomes between the treatment and control groups) or another test statistic produced by the experiment.[6] A single study will typically not involve replications of the experiment, but separate studies may be aggregated through systematic review and meta-analysis. Of course, these differences between experimental practice in each of the branches of science have exceptions. For example, agricultural research frequently uses randomized experiments (e.g., to test the comparative effectiveness of different fertilizers). Similarly, experimental economics often involves experimental tests of theorized human behaviors without relying on random assignment of individuals to treatment and control conditions.[7] History[edit] Main article: History of experiments Frontispiece of book showing two persons in robes, one holding a geometrical diagram, the other holding a telescope. Hevelius's Selenographia, showing Alhasen [sic] representing reason, and Galileo representing the senses. “ The duty of the man who investigates the writings of scientists, if learning the truth is his goal, is to make himself an enemy of all that he reads, and,.. attack it from every side. He should also suspect himself as he performs his critical examination of it, so that he may avoid falling into either prejudice or leniency. ” —Alhazen, [8] One aspect associated with the optical research of Alhazen (c. 965 – c. 1040 CE) relates to systemic and methodological reliance on experimentation (i'tibar)(Arabic: ??????) and controlled testing in his scientific inquiries. Moreover, his experimental directives rested on combining classical physics (ilm tabi'i) with mathematics (ta'alim; geometry in particular). This mathematical-physical approach to experimental science supported most of his propositions in Kitab al-Manazir (The Optics; De aspectibus or Perspectivae) and grounded his theories of vision, light and colour, as well as his research in catoptrics and in dioptrics (the study of the refraction of light).[9] Bradley Steffens in his book Ibn Al-Haytham: First Scientist has argued that Alhazen's approach to testing and experimentation made an important contribution to the scientific method. According to Matthias Schramm, Alhazen: was the first to make a systematic use of the method of varying the experimental conditions in a constant and uniform manner, in an experiment showing that the intensity of the light-spot formed by the projection of the moonlight through two small apertures onto a screen diminishes constantly as one of the apertures is gradually blocked up.[10] G. J. Toomer expressed some skepticism regarding Schramm's view, arguing that caution is needed to avoid reading anachronistically particular passages in Alhazen's very large body of work, and while acknowledging Alhazen's importance in developing experimental techniques, argued that he should not be considered in isolation from other Islamic and ancient thinkers.[11] Francis Bacon (1561–1626), an English philosopher and scientist active in the 17th century, became an early and influential supporter of experimental science. He disagreed with the method of answering scientific questions by deduction and described it as follows: "Having first determined the question according to his will, man then resorts to experience, and bending her to conformity with his placets, leads her about like a captive in a procession."[12] Bacon wanted a method that relied on repeatable observations, or experiments. Notably, he first ordered the scientific method as we understand it today. There remains simple experience; which, if taken as it comes, is called accident, if sought for, experiment. The true method of experience first lights the candle [hypothesis], and then by means of the candle shows the way [arranges and delimits the experiment]; commencing as it does with experience duly ordered and digested, not bungling or erratic, and from it deducing axioms [theories], and from established axioms again new experiments. — Francis Bacon. Novum Organum. 1620.[13] In the centuries that followed, people who applied the scientific method in different areas made important advances and discoveries. For example, Galileo Galilei (1564-1642) accurately measured time and experimented to make accurate measurements and conclusions about the speed of a falling body. Antoine Lavoisier (1743-1794), a French chemist, used experiment to describe new areas, such as combustion and biochemistry and to develop the theory of conservation of mass (matter).[14] Louis Pasteur (1822-1895) used the scientific method to disprove the prevailing theory of spontaneous generation and to develop the germ theory of disease.[15] Because of the importance of controlling potentially confounding variables, the use of well-designed laboratory experiments is preferred when possible. A considerable amount of progress on the design and analysis of experiments occurred in the early 20th century, with contributions from statisticians such as Ronald Fisher (1890-1962), Jerzy Neyman (1894-1981), Oscar Kempthorne (1919-2000), Gertrude Mary Cox (1900-1978), and William Gemmell Cochran (1909-1980), among others. This early work has largely been synthesized[by whom?] under the label of the Rubin causal model, which formalizes earlier statistical approaches to the analysis of experiments. Types of experiment[edit] Experiments might be categorized according to a number of dimensions, depending upon professional norms and standards in different fields of study. In some disciplines (e.g., Psychology or Political Science), a 'true experiment' is a method of social research in which there are two kinds of variables. The independent variable is manipulated by the experimenter, and the dependent variable is measured. The signifying characteristic of a true experiment is that it randomly allocates the subjects in order to neutralize the potential for experimenter bias and ensures, over a large number of iterations of the experiment, that all confounding factors are controlled for.[16][17] Controlled experiments[edit] Main article: Scientific control Main article: Design of experiments A controlled experiment often compares the results obtained from experimental samples against control samples, which are practically identical to the experimental sample except for the one aspect whose effect is being tested (the independent variable). A good example would be a drug trial. The sample or group receiving the drug would be the experimental group (treatment group); and the one receiving the placebo or regular treatment would be the control one. In many laboratory experiments it is good practice to have several replicate samples for the test being performed and have both a positive control and a negative control. The results from replicate samples can often be averaged, or if one of the replicates is obviously inconsistent with the results from the other samples, it can be discarded as being the result of an experimental error (some step of the test procedure may have been mistakenly omitted for that sample). Most often, tests are done in duplicate or triplicate. A positive control is a procedure that is very similar to the actual experimental test but which is known from previous experience to give a positive result. A negative control is known to give a negative result. The positive control confirms that the basic conditions of the experiment were able to produce a positive result, even if none of the actual experimental samples produce a positive result. The negative control demonstrates the base-line result obtained when a test does not produce a measurable positive result. Most often the value of the negative control is treated as a "background" value to be subtracted from the test sample results. Sometimes the positive control takes the quadrant of a standard curve. An example that is often used in teaching laboratories is a controlled protein assay. Students might be given a fluid sample containing an unknown (to the student) amount of protein. It is their job to correctly perform a controlled experiment in which they determine the concentration of protein in fluid sample (usually called the "unknown sample"). The teaching lab would be equipped with a protein standard solution with a known protein concentration. Students could make several positive control samples containing various dilutions of the protein standard. Negative control samples would contain all of the reagents for the protein assay but no protein. In this example, all samples are performed in duplicate. The assay is a colorimetric assay in which a spectrophotometer can measure the amount of protein in samples by detecting a colored complex formed by the interaction of protein molecules and molecules of an added dye. In the illustration, the results for the diluted test samples can be compared to the results of the standard curve (the blue line in the illustration) in order to determine an estimate of the amount of protein in the unknown sample. Controlled experiments can be performed when it is difficult to exactly control all the conditions in an experiment. In this case, the experiment begins by creating two or more sample groups that are probabilistically equivalent, which means that measurements of traits should be similar among the groups and that the groups should respond in the same manner if given the same treatment. This equivalency is determined by statistical methods that take into account the amount of variation between individuals and the number of individuals in each group. In fields such as microbiology and chemistry, where there is very little variation between individuals and the group size is easily in the millions, these statistical methods are often bypassed and simply splitting a solution into equal parts is assumed to produce identical sample groups. Once equivalent groups have been formed, the experimenter tries to treat them identically except for the one variable that he or she wishes to isolate. Human experimentation requires special safeguards against outside variables such as the placebo effect. Such experiments are generally double blind, meaning that neither the volunteer nor the researcher knows which individuals are in the control group or the experimental group until after all of the data have been collected. This ensures that any effects on the volunteer are due to the treatment itself and are not a response to the knowledge that he is being treated. In human experiments, a subject (person) may be given a stimulus to which he or she should respond. The goal of the experiment is to measure the response to a given stimulus by a test method. Original map by John Snow showing the clusters of cholera cases in the London epidemic of 1854 In the design of experiments, two or more "treatments" are applied to estimate the difference between the mean responses for the treatments. For example, an experiment on baking bread could estimate the difference in the responses associated with quantitative variables, such as the ratio of water to flour, and with qualitative variables, such as strains of yeast. Experimentation is the step in the scientific method that helps people decide between two or more competing explanations – or hypotheses. These hypotheses suggest reasons to explain a phenomenon, or predict the results of an action. An example might be the hypothesis that "if I release this ball, it will fall to the floor": this suggestion can then be tested by carrying out the experiment of letting go of the ball, and observing the results. Formally, a hypothesis is compared against its opposite or null hypothesis ("if I release this ball, it will not fall to the floor"). The null hypothesis is that there is no explanation or predictive power of the phenomenon through the reasoning that is being investigated. Once hypotheses are defined, an experiment can be carried out - and the results analysed - in order to confirm, refute, or define the accuracy of the hypotheses. Natural experiments[edit] Main article: Natural experiment The term "experiment" usually implies a controlled experiment, but sometimes controlled experiments are prohibitively difficult or impossible. In this case researchers resort to natural experiments or quasi-experiments.[18] Natural experiments rely solely on observations of the variables of the system under study, rather than manipulation of just one or a few variables as occurs in controlled experiments. To the degree possible, they attempt to collect data for the system in such a way that contribution from all variables can be determined, and where the effects of variation in certain variables remain approximately constant so that the effects of other variables can be discerned. The degree to which this is possible depends on the observed correlation between explanatory variables in the observed data. When these variables are not well correlated, natural experiments can approach the power of controlled experiments. Usually, however, there is some correlation between these variables, which reduces the reliability of natural experiments relative to what could be concluded if a controlled experiment were performed. Also, because natural experiments usually take place in uncontrolled environments, variables from undetected sources are neither measured nor held constant, and these may produce illusory correlations in variables under study. Much research in several important science disciplines, including economics, political science, geology, paleontology, ecology, meteorology, and astronomy, relies on quasi-experiments. For example, in astronomy it is clearly impossible, when testing the hypothesis "suns are collapsed clouds of hydrogen", to start out with a giant cloud of hydrogen, and then perform the experiment of waiting a few billion years for it to form a sun. However, by observing various clouds of hydrogen in various states of collapse, and other implications of the hypothesis (for example, the presence of various spectral emissions from the light of stars), we can collect data we require to support the hypothesis. An early example of this type of experiment was the first verification in the 17th century that light does not travel from place to place instantaneously, but instead has a measurable speed. Observation of the appearance of the moons of Jupiter were slightly delayed when Jupiter was farther from Earth, as opposed to when Jupiter was closer to Earth; and this phenomenon was used to demonstrate that the difference in the time of appearance of the moons was consistent with a measurable speed. Field experiments[edit] Main article: Field experiment Field experiments are so named in order to draw a contrast with laboratory experiments, which enforce scientific control by testing a hypothesis in the artificial and highly controlled setting of a laboratory. Often used in the social sciences, and especially in economic analyses of education and health interventions, field experiments have the advantage that outcomes are observed in a natural setting rather than in a contrived laboratory environment. For this reason, field experiments are sometimes seen as having higher external validity than laboratory experiments. However, like natural experiments, field experiments suffer from the possibility of contamination: experimental conditions can be controlled with more precision and certainty in the lab. Yet some phenomena (e.g., voter turnout in an election) cannot be easily studied in a laboratory. Contrast with observational study[edit] An observational study is used when it is impractical, unethical, cost-prohibitive (or otherwise inefficient) to fit a physical or social system into a laboratory setting, to completely control confounding factors, or to apply random assignment. It can also be used when confounding factors are either limited or known well enough to analyze the data in light of them (though this may be rare when social phenomena are under examination). In order for an observational science to be valid, confounding factors must be known and accounted for. In these situations, observational studies have value because they often suggest hypotheses that can be tested with randomized experiments or by collecting fresh data. Fundamentally, however, observational studies are not experiments. By definition, observational studies lack the manipulation required for Baconian experiments. In addition, observational studies (e.g., in biological or social systems) often involve variables that are difficult to quantify or control. Observational studies are limited because they lack the statistical properties of randomized experiments. In a randomized experiment, the method of randomization specified in the experimental protocol guides the statistical analysis, which is usually specified also by the experimental protocol.[19] Without a statistical model that reflects an objective randomization, the statistical analysis relies on a subjective model.[19] Inferences from subjective models are unreliable in theory and practice.[20] In fact, there are several cases where carefully conducted observational studies consistently give wrong results, that is, where the results of the observational studies are inconsistent and also differ from the results of experiments. For example, epidemiological studies of colon cancer consistently show beneficial correlations with broccoli consumption, while experiments find no benefit.[21] A particular problem with observational studies involving human subjects is the great difficulty attaining fair comparisons between treatments (or exposures), because such studies are prone to selection bias, and groups receiving different treatments (exposures) may differ greatly according to their covariates (age, height, weight, medications, exercise, nutritional status, ethnicity, family medical history, etc.). In contrast, randomization implies that for each covariate, the mean for each group is expected to be the same. For any randomized trial, some variation from the mean is expected, of course, but the randomization ensures that the experimental groups have mean values that are close, due to the central limit theorem and Markov's inequality. With inadequate randomization or low sample size, the systematic variation in covariates between the treatment groups (or exposure groups) makes it difficult to separate the effect of the treatment (exposure) from the effects of the other covariates, most of which have not been measured. The mathematical models used to analyze such data must consider each differing covariate (if measured), and the results will not be meaningful if a covariate is neither randomized nor included in the model. To avoid conditions that render an experiment far less useful, physicians conducting medical trials, say for U.S. Food and Drug Administration approval, will quantify and randomize the covariates that can be identified. Researchers attempt to reduce the biases of observational studies with complicated statistical methods such as propensity score matching methods, which require large populations of subjects and extensive information on covariates. Outcomes are also quantified when possible (bone density, the amount of some cell or substance in the blood, physical strength or endurance, etc.) and not based on a subject's or a professional observer's opinion. In this way, the design of an observational study can render the results more objective and therefore, more convincing. Ethics[edit] Main article: Research ethics By placing the distribution of the independent variable(s) under the control of the researcher, an experiment - particularly when it involves human subjects - introduces potential ethical considerations, such as balancing benefit and harm, fairly distributing interventions (e.g., treatments for a disease), and informed consent. For example in psychology or health care, it is unethical to provide a substandard treatment to patients. Therefore, ethical review boards are supposed to stop clinical trials and other experiments unless a new treatment is believed to offer benefits as good as current best practice.[22] It is also generally unethical (and often illegal) to conduct randomized experiments on the effects of substandard or harmful treatments, such as the effects of ingesting arsenic on human health. To understand the effects of such exposures, scientists sometimes use observational studies to understand the effects of those factors. Even when experimental research does not directly involve human subjects, it may still present ethical concerns. For example, the nuclear bomb experiments conducted by the Manhattan Project implied the use of nuclear reactions to harm human beings even though the experiments did not directly involve any human subjects. Experimental method in Law[edit] The experimental method can be useful in solving juridical problems (R. Zippelius, Die experimentierende Methode im Recht, 1991, ISBN 3-515-05901-6). See also[edit] Design of experiments Experimental physics List of experiments Long-term experiment Concept development and experimentation Further reading[edit] Dunning, Thad. Natural Experiments in the Social Sciences: A Design-Based Approach. Cambridge University Press. Shadish, William R., Thomas D. Cook, and Donald T. Campbell. (2001) Experimental and Quasi-experimental Designs for Generalized Causal Inference. Boston: Houghton Mifflin. ISBN 0-395-61556-9 Excerpts Teigen, Jeremy. 2014. "Experimental Methods in Military and Veteran Studies." in Routledge Handbook of Research Methods in Military Studies edited by Soeters, Joseph; Shields, Patricia and Rietjens, Sebastiaan. pp.228 - 238. New York: Routledge. External links[edit] Library resources about Experiment Resources in your library Lessons In Electric Circuits - Volume VI - Experiments Description of weird experiments (with film clips) Science Experiments for Kids Science Project ideas Experiment in Physics from Stanford Encyclopedia of Philosophy Kids Science Experiments [show] v t e Design of experiments [show] v t e Statistics Categories: Research Design of experimentsScience experimentsEvaluation methodsCausal inferenceExperiments THANKS FOR LOOKING!!! tele3lb

Condition	For parts or not working : An item that does not function as intended and is not fully operational. This includes items that are defective in ways that render them difficult to use, items that require service or repair, or items missing essential components. See the seller’s listing for full details.
Seller Notes	“So-so condition, some homework pages ripped out, filled in, but includes the CD ROM.”