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Efficacy, effectiveness, efficiency的区别

Efficacy, effectiveness, efficiency的区别
Efficacy, effectiveness, efficiency的区别

Australian Prescriber Vol. 23 No. 6 2000

E D I T O R I A L

Efficacy, effectiveness, efficiency John Marley, Professor, Department of General Practice, University of Adelaide, Adelaide

Index words: drug utilisation, cost-effectiveness, drug evaluation.

(Aust Prescr 2000;23:114–5) How is it, that guidelines for treatment often seem unrelated to the patient sitting in front of the doctor? Guidelines are mostly based on evidence gathered from randomised controlled trials. These trials are very good at assessing efficacy – that is, can a treatment work? Despite this, trials are not without substantial biases. Many people may be screened before a few are chosen to be included in a study, yet the results of the study will be applied to the very people who were excluded. The population studied in trials tends to be young, male, white, suffering from a single condition and using a single treatment. Most patients, at least in general practice, do not fit this description. They often have multiple illnesses, take multiple medications and are either too young or too old to have been included in clinical trials. Perhaps we should accept a proposal to define efficacy in relation to medications as ‘the extent to which a drug has the ability to bring about its intended effect under ideal circumstances, such as in a randomised clinical trial’.*Efficacy is not the same as effectiveness.1 A treatment is effective if it works in real life in non-ideal circumstances. In real life, medications will be used in doses and frequencies never studied and in patient groups never assessed in the trials. Drugs will be used in combination with other medications that have not been tested for interactions, and by people other than the patient – the ‘over the garden fence’ syndrome. Effectiveness cannot be measured in controlled trials, because the act of inclusion into a study is a distortion of usual practice. Effectiveness can be defined as ‘the extent to which a drug achieves its intended effect in the usual clinical setting’.* It can be evaluated through observational studies of real practice. This allows practice to be assessed in qualitative as well as quantitative terms.2

Australia is well suited to conduct observational studies because we have a high standard of relatively unrestricted practice and good national databases, such as those held by the Health Insurance Commission. These databases can be used for validating researchers’ separate database effectiveness studies. In America there are very large patient databases held by the Health Maintenance Organisations. Their size is impressive, but size is not everything. The data may have been collected primarily for billing and they may be incomplete. Clinical practice is often governed by protocols, and medications are limited to those supplied by the current preferred providers. The reimbursement mechanism for doctors may mean that they code conditions at the highest severity level. Patients belonging to one of these organisations may not represent the American population as a whole. In Britain, the General Practice Research Database, compiled from practice electronic records, is very useful, especially for studies in pharmacoepidemiology. The British enjoy relatively unrestricted clinical practice, but they do not have readily usable national datasets against which to check the validity of their database studies.

It is an irony that drugs are licensed for use almost exclusively on the results of controlled trials, yet they are withdrawn from use because of observational data that would not be acceptable to licensing authorities. Biases are present in observational studies, just as they are in trials, but they can be defined and often controlled for, giving these studies a much greater value than that currently awarded to them.

*From a suggested dictionary of pharmacoepidemiology by

C. Ineke Neutel, University of Ottawa Institute on Health of

the Elderly, Research Department, SCO Health Services.

43 Bruyere Street, Ottawa CANADA K1N 5C8.

114

Australian Prescriber Vol. 23 No. 6 2000

Efficiency depends on whether a drug is worth its cost to individuals or society. The most efficacious treatment, based on the best evidence, may not be the most cost-effective option. It may not be acceptable to patients. In every country, rationing of health care is a reality. There is no country, however wealthy, that can afford to deliver all the health care possible to the whole of its population at all times. Rationing may be implicit or explicit, but it will happen. Good effectiveness and efficiency studies will make this rationing more informed.

Good practical guidelines, such as the Therapeutic Guidelines series, are clearly very important and extremely useful. They could be made even more relevant to the patient in front of the doctor, by being less dependent on efficacy studies. We should make more use of effectiveness and efficiency studies and abandon the censorship of the evidence drawn from them. R E F E R E N C E S

1.Haynes B. Can it work? Does it work? Is it worth it? Br Med J 1999;319:

652-3.

2.Greenhalgh T. Is my practice evidence-based? Br Med J 1996;313:957-8. E-mail: john.marley@https://www.sodocs.net/doc/a66894670.html,.au

115

销售队伍效力(Sales Force Effectiveness)

驱动赢利性增长,从“改进销售队伍效力”开始 SFE :提升销售业绩和获得赢利性增长的新路径 制药企业应当如何做才能快速促进销售增长,获得较高的投入产出回报(ROI)呢? 制药企业实现赢利性销售增长的机会在于:改变以往“大规模销售队伍驱动和大数量客户促销”的模式,果断采用“改进销售队伍效力”的模式(Improving Sales Force Effectiveness)--“通过针对性地为恰当的客户提供恰当的产品/服务,给予销售队伍以更有效的工具及销售方法、更好的时间利用和更高的销售技能来提高生产力,从而优化销售投入,扩大销售产出,增加利润回报” 销售队伍效力(Sales Force Effectiveness)也即“销售队伍的效率和效能”,它是一项涉及“企业制定完市场策略后,销售队伍如何实现最佳销售业绩?”的管理实践活动,最大化销售队伍的效率和生产力,其焦点在于“建立一支高绩效的销售队伍”。以七和咨询的经验,一支高绩效的销售团队应当具备以下方面的成功要素(见图示一): 最大化销售队伍的效率和效能,可以使企业通过一些局部的管理改进就能快速创造巨大价值,这种变化并不一定需要增加销售人员数量和投入大量资金,通常只需数月便可卓有成效。在可以预知的将来,“改进销售队伍效力”将成为企业销售管理者面对的首要挑战。 制药企业如何系统地改进销售队伍的效力?

由于影响企业“销售队伍效力”差距的因素不仅可能存在于企业内部(战略及战术、人员、流程及基础架构),也可能存在企业外部(市场竞争、客户需求变化等),所以,制药企业在改进销售队伍的效力时,我们建议采用以下5个系统性的关键步骤: 步骤一:诊断和确认销售队伍效力改进的潜在机会点 ?企业组建跨部门联合项目团队(销售、市场、HR/ 销售培训、客户服务、IT),沿“销售队伍效力金字塔”(见图示二)的三个层面(客户战略层面、销售组织结构与流程层面、支持工具层面)逐一评估销售队伍在每一个层面运行的情况,以及三个层面彼此之间协调一致的情况; ?研究制药行业的最佳销售实践,将公司当前的销售能力与领先竞争企业进行基准比照; ?综合评价公司当前销售队伍的绩效状况、分析存在的差距及问题原因; ?确定销售队伍效力改进的潜在机会点。 步骤二:将潜在机会点进行优先性排序 企业应根据自身的财力状况、战略发展需要、风险大小、时间-结果要求等因素,对销售队伍效力改进的潜在机会点进行优先性排序,应该尽可能快地实施那些既能创造高价值业绩增长而又只需要进行局部管理改进的“潜在机会点”,以获得短期“快赢”的成果。 步骤三:制定销售队伍效力改进方案 针对优先性的潜在机会点,企业需要制定一套销售队伍效力改进方案。基于七和咨询对制药行业的研究和我们的咨询项目经历,我们发现了一些影响制药企业销售队伍效力差距的普遍性问题,并且确认了 8 个提升销售队伍绩效的关键原则,提供企业参考:

effect,effective,effectiveness,efficiency,efficacy和potency

Effect影响,效果adverse effect 副作用 Effective管用的,有效的effective method 有用的方法 Effectiveness 1. 有效性,管用性. I doubt the effectiveness of the medicine. 我怀疑这种药的有效性。 2. 效益,更宽泛一些, 不那么具体, 指整体的有效程度。 3. (实际)效果,可指在临床实践中(即临床实际应用时)药物或治疗方案的起效程度(与efficacy相反)。 Efficiency 1. 效率(规定时间内的成果),比如一个人,一个机器的效率每人每天能做多少事情。 The efficiency of a washing machine in washing clothes in much higher than that of a man. 洗衣机洗衣服的效率比人高多了。 Efficacy功效,(理想)效力,比如预期疗效。 collective Efficacy 集体效能 Potency效能,力量,潜力,权势,多指药物的生物效能。 toxic potency 毒效 “正确地做事”强调的是效率(effciency),其结果是让我们更快地朝目标迈进;“做正确的事”强调的则是效能(effectivenss),其结果是确保我们的工作是在坚实地朝着自己的目标迈进。 管理大师彼得·德鲁克曾在《有效的主管》一书中简明扼要地指出:“效率是‘以正确的方式做事’,而效能则是“做正确的事”。效率和效能不应偏废,但这并不意味着效率和效能具有同样的重要性。我们当然希望同时提高效率和效能,但在效率与效能无法兼得时,首先应着眼于效能,然后设法提高效率。 “正确地做事”强调的是效率,其结果是让我们更快地朝目标迈进;“做正确的事”强调的则是效能,其结果是确保我们的工作是在坚实地朝着自己的目标迈进。换句话说,效率重视的是做一件工作的最好方法,效能则重视时间的最佳利用——这包括做或是不做某一项工作。麦肯锡卓越工作方法的最大秘诀就是,每一个麦肯锡人在开始工作前必须先确保自己是在“做正确的事”。“正确地做事”是以“做正确的事”为前提。

可靠性术语

本文介绍常用可靠性维修性术中英文对照,方便大家使用!可靠性 reliability 维修性 maintainability 可用性 availability 可信性 dependability 耐久性 durability 效能 effectiveness 固有能力 capability 修理的产品 repaired item 不修理的产品 non-repaired item 服务 service 规定功能 required function 时刻 instant of time 时间区间 time interval 持续时间 time duration 累积时间 accumulated time 量度 measure 工作 operation 修改(对产品而言) modification (of an item) 维修保障性 maintenance support performance 失效 failure 致命失效 critical failure 非致命失效 non-critical failure 误用失效 misuse failure 误操作失效 mishandling failure 弱质失效 weakness failure 设计失效 design failure 制造失效 manufacture failure 老化失效;耗损失效 ageing failure; wear-out failure 突然失效 sudden failure 渐变失效;漂移失效 gradual failure; drift failure 灾变失效 cataleptic failure 关联失效 relevant failure 非关联失效 non-relevant failure

The Unreasonable Effectiveness of Mathematics in the Natural Sciences

The Unreasonable E?ectiveness of Mathematics in the Natural Sciences by Eugene Wigner1 “Mathematics,rightly viewed,possesses not only truth,but supreme beauty,a beauty cold and austere,like that of sculpture,without appeal to any part of our weaker nature,without the gorgeous trappings of painting or music,yet sublimely pure,and capable of a stern perfection such as only the greatest art can show.The true spirit of delight,the exaltation,the sense of being more than Man,which is the touchstone of the highest excellence,is to be found in mathematics as surely as in poetry.” Bertrand Russell,Study of Mathematics There is a story about two friends,who were classmates in high school,talking about their jobs.One of them became a statistician and was working on population trends.He showed a reprint to his former classmate.The reprint started,as usual,with the Gaussian distribution and the statistician explained to his former classmate the meaning of the symbols for the actual population,for the average population,and so on.His classmate was a bit incredulous and was not quite sure whether the statistician was pulling his leg.“How can you know that?”was his query.“And what is this symbol here?”“Oh,”said the statistician,“this is pi.”“What is that?”“The ratio of the circumference of the circle to its diameter.”“Well,now you are pushing your joke too far,”said the classmate,“surely the population has nothing to do with the circumference of the circle.”Naturally,we are inclined to smile about the simplicity of the classmate’s approach.Nevertheless,when I heard this story,I had to admit to an eerie feeling because,surely,the reaction of the classmate betrayed only plain common sense.I was even more confused when,not many days later,someone came to me and expressed his bewilderment2with the fact that we make a rather narrow selection when choosing the data on which we test our theories.“How do we know that,if we made a theory which focuses its attention on phenomena we disregard and disregards some of the phenomena now commanding our attention,that we could not build another theory which has little in common with the present one but which,nevertheless,explains just as many phenomena as the present theory?”It has to be admitted that we have no de?nite evidence that there is no such theory. The preceding two stories illustrate the two main points which are the subjects of the present discourse.The?rst point is that mathematical concepts turn up in entirely unexpected con-nections.Moreover,they often permit an unexpectedly close and accurate description of the phenomena in these connections.Secondly,just because of this circumstance,and because we do not understand the reasons of their usefulness,we cannot know whether a theory formulated in terms of mathematical concepts is uniquely appropriate.We are in a position similar to that of a man who was provided with a bunch of keys and who,having to open several doors in suc-cession,always hit on the right key on the?rst or second trial.He became skeptical concerning the uniqueness of the coordination between keys and doors. Most of what will be said on these questions will not be new;it has probably occurred to most scientists in one form or another.My principal aim is to illuminate it from several sides.The ?rst point is that the enormous usefulness of mathematics in the natural sciences is something bordering on the mysterious and that there is no rational explanation for it.Second,it is just this uncanny usefulness of mathematical concepts that raises the question of the uniqueness of our 1Eugene Wigner,“The Unreasonable E?ectiveness of Mathematics in the Natural Sciences,”in Communica-tions in Pure and Applied Mathematics,vol.13,No.I(February1960).New York:John Wiley&Sons,Inc. Copyright1960by John Wiley&Sons,Inc. 2The remark to be quoted was made by F.Werner when he was a student in Princeton.

效能评估与绩效评估的异同

效能评估与绩效评估的异同 ——以土地督察效能评估为例 【摘要】在实践中公共部门的效能评估与绩效评估是一对容易被混淆使用的概念,但也有学者认为绩效评估范围更广,应包含效能评估。本文通过同时开展的两个评估:“土地督察效能评估”、“土地督察绩效评估”对比分析,归纳了公共部门效能评估与绩效评估的异同。 【关键词】效能评估、绩效评估

一、效能评估与绩效评估概述 (一)绩效与效能 1、绩效 在新公共管理运动的影响下,“绩效”一词被广泛熟知,绩效研究成为公共管理领域的一个热门课题。目前国内外对于公共部门绩效的研究不管是在学术理论方面还是实践方面成果颇丰。“绩效”(performance)最早来源于企业可计算的利润来表达。随着社会经济和企业管理发展的需求,绩效的含义逐渐拓展为“组织对资源的有效、高效及安全的运用,与运营和功能的有效性相关”。① 朱春奎在《公共部门绩效评估:方法与应用》一书中,从管理学、经济学和社会学角度对“绩效”进行了考察,管理学角度,绩效是组织期望的结果,是组织为实现其目标而展现在不同层面上的有效输出,包括个人绩效和组织绩效两个方面;经济学角度,绩效是员工对组织的承诺,作为对等的承诺关系,薪酬便是组织对员工的承诺,其本质就是市场经济中的等价交换关系;社会学角度来看,绩效意味着每一个社会成员按照社会分工所确定的角色承担他的那一份职责。②学者卓越③通过对绩效与效率进行比较分析的基础上,认为“效率是一个单向度的概念,而绩效是一个综合性的范畴。”并且将公共部门绩效定义为:公共部门在积极履行公共责任的过程中,在讲求内部管理与外部效应、数量与质量、经济因素和伦理政治因素、刚性规范与柔性机制相统一的基础上,获得的公共产出最大化。德国政治学家汉斯?班贝格对绩效单从经济角度来考量也是持否定态度的,他认为节约开支是首要任务而非所为提高效能,成本核算和绩效指标体系将会导致忽略外部经济、社会环境的影响。④可见,绩效被引入到公共管理领域后,其内涵更加丰富,也更加符合现代国家建设中顾客至上,服务政府的理念。 2、效能 ①胡税根著.公共部门绩效管理:迎接效能革命的挑战[M],浙江大学出版社,2008.11. ②朱春奎等著.公共部门绩效评估:方法与应用[M],北京,中国财政经济出版社,2007.09. ③卓越主编.公共部门绩效评估[M],北京,中国人民大学出版社,2004.11. ④ [德]汉斯?班贝格.德国的行政现代化:新瓶装旧酒[M],转引自西方国家行政改革述评[M].北京,国家 行政学院出版,1998.

Efficacy, effectiveness, efficiency的区别

Australian Prescriber Vol. 23 No. 6 2000 E D I T O R I A L Efficacy, effectiveness, efficiency John Marley, Professor, Department of General Practice, University of Adelaide, Adelaide Index words: drug utilisation, cost-effectiveness, drug evaluation. (Aust Prescr 2000;23:114–5) How is it, that guidelines for treatment often seem unrelated to the patient sitting in front of the doctor? Guidelines are mostly based on evidence gathered from randomised controlled trials. These trials are very good at assessing efficacy – that is, can a treatment work? Despite this, trials are not without substantial biases. Many people may be screened before a few are chosen to be included in a study, yet the results of the study will be applied to the very people who were excluded. The population studied in trials tends to be young, male, white, suffering from a single condition and using a single treatment. Most patients, at least in general practice, do not fit this description. They often have multiple illnesses, take multiple medications and are either too young or too old to have been included in clinical trials. Perhaps we should accept a proposal to define efficacy in relation to medications as ‘the extent to which a drug has the ability to bring about its intended effect under ideal circumstances, such as in a randomised clinical trial’.*Efficacy is not the same as effectiveness.1 A treatment is effective if it works in real life in non-ideal circumstances. In real life, medications will be used in doses and frequencies never studied and in patient groups never assessed in the trials. Drugs will be used in combination with other medications that have not been tested for interactions, and by people other than the patient – the ‘over the garden fence’ syndrome. Effectiveness cannot be measured in controlled trials, because the act of inclusion into a study is a distortion of usual practice. Effectiveness can be defined as ‘the extent to which a drug achieves its intended effect in the usual clinical setting’.* It can be evaluated through observational studies of real practice. This allows practice to be assessed in qualitative as well as quantitative terms.2 Australia is well suited to conduct observational studies because we have a high standard of relatively unrestricted practice and good national databases, such as those held by the Health Insurance Commission. These databases can be used for validating researchers’ separate database effectiveness studies. In America there are very large patient databases held by the Health Maintenance Organisations. Their size is impressive, but size is not everything. The data may have been collected primarily for billing and they may be incomplete. Clinical practice is often governed by protocols, and medications are limited to those supplied by the current preferred providers. The reimbursement mechanism for doctors may mean that they code conditions at the highest severity level. Patients belonging to one of these organisations may not represent the American population as a whole. In Britain, the General Practice Research Database, compiled from practice electronic records, is very useful, especially for studies in pharmacoepidemiology. The British enjoy relatively unrestricted clinical practice, but they do not have readily usable national datasets against which to check the validity of their database studies. It is an irony that drugs are licensed for use almost exclusively on the results of controlled trials, yet they are withdrawn from use because of observational data that would not be acceptable to licensing authorities. Biases are present in observational studies, just as they are in trials, but they can be defined and often controlled for, giving these studies a much greater value than that currently awarded to them. *From a suggested dictionary of pharmacoepidemiology by C. Ineke Neutel, University of Ottawa Institute on Health of the Elderly, Research Department, SCO Health Services. 43 Bruyere Street, Ottawa CANADA K1N 5C8. 114

可靠性专业术语集

效能 effectiveness 系统效能 system effectiveness 费用效能 cost effectiveness 作战效能 operational effectiveness 作战适用性 operational suitability 持续作战能力 sustainability 战备完好性 operational readiness 系统战备完好性 system operational readiness 系统战备完好性目标 system readiness objective 装备完好率 materiel readiness 可用性 availability 固有可用度 inherent availability (Ai) 可达可用度 achieved availability (Aa) 使用可用度 operational availability (Ao) 能执行任务率 mission capable rate (MCR) 出动架次率 sortie generation rate (SGR) 在轨可用度 orbital availability 可信性 dependability 保障性 supportability 可靠性 reliability 耐久性 durability 维修性 maintainability 测试性 testability 安全性 safety 完整性 integrity 生存性 survivability 生产性 producibility 互用性 interoperability 兼容性 compatibility 经济承受性 affordability 能力 capability 固有能力 capability 作战能力 operational capability 初始作战能力 initial operational capability (IOC) 全面作战能力 full operational capability (FOC) 1

公司董事会属性、团队效能和财务绩效[文献翻译]

原文: Corporate Board Attributes, Team Effectiveness and Financial Performance A Team-Based Model of Corporate Board Effectiveness The existing literature examining teams and knowledge-based work groups demonstrates a causal link between team practices or attributes, effectiveness, and outcomes (Cohen and Bailey, 1997; Kirkman and Rosen, 1999; Marks et al., 2001). Extending on the literature regarding team effectiveness, some governance scholars have started to focus on managerial competence and empowerment arguments to help explain organizational performance differences (Davis et al., 1997; Hendry, 2002; Shen, 2003). In their seminal theoretical work, Forbes and Milliken (1999) integrated literature on corporate boards and team effectiveness arguing that board effectiveness is identified by the same criteria as many previous models of team effectiveness. Further, they suggest that the various board demographics typically used in board research, such as insider/outsider ratio, board size, and tenure, are expected to influence overall team effectiveness independently. Similarly, Sonnenfeld (2002) describes effective boards as being distinguished by ‘robust, effective social systems’ and contends that board demographics between Forbes Magazine’s (2001) most-admired and least-admired companies are actually similar. This suggests that structural characteristics in and of themselves do not differentiate between high-performing and low-performing boards. Sonnenfeld (2002, p. 106) goes on to state, ‘We need to consider not only how we structure the work of a board but also how we manage the social system a board actually is.’ This is consistent with the conclusion of Papadakis et al. (1998) that decision-specific and relationship attributes, rather than board demographics, represent the greatest influence on the strategic decision-making process. Drawing from both the corporate board and groups/teams research, we argue that the same conditions enabling workgroups to achieve their goals should be related to corporate board effectiveness. Others have acknowledged this relationship, but in a

How to Balance Effectiveness and Efficiency in Management

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详析Accountability与Responsibility的区别

当责对应负责的8个比照 在现代管理中,accountability(当责)与responsibility(负责)已有明显分野,这种 分野并在流程/项目管理、产品/软件开发等等活动中协助厘清关键性的不同角色与责任。角色与责任厘清后,绝对有助于提升活动的“有效性”:含effectiveness(有效果)与efficiency(有效率)。 由下列8实例中,我们将深入了解“当责”与“负责”的明显分野,也将有助于进一步了解当责真义。 1 当责原理第一例 前文曾提及美国橡树岭科技教育学院与加州大学对当责与负责所做的区别说明。下述第一例,有相当类似的说法;提出的则是在安达信顾问公司(Accenture)有约30年顾问经验的资深主管包盖思博士(Keith Burgess)及其研究人员。 负责(responsibility)是: The obligation to act or to produce. 亦即有义务采取行动或有所产出。 当责(accountability)是: The obligation one assumes for ensuring these responsibilities are delivered. 亦即有义务确保这些行动责任确能交出成果来。 所以,一个有当责的经理人,应该首先负责对已定案的计划采取行动,然后还要对这些行动/任务的确定完成,负起全责。 为“成果”负“当责”(accountable for results)是组织每一阶层经理人当尽的义务,不论这个组织是营利性或非营利性的。 也许,一个更简单的实例是邮寄物品吧:准时、依规把物品寄出,就是负责;如能再追踪收件人,确认是否收到,是为当责。为确实达成任务,甚至还思考何种投递方式、何家公司更可靠,这就是当责中的为所当为了。等而下之的,就试试这些人:“已依规定寄出;你问我,

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