Glossary: the terms on these templates, defined plainly

Grouped by the sheet where the term is most likely to be met. Each entry links to that sheet.

On the dose log and shot-day checklist

Dose as written by the prescriber. The strength and amount on your prescription label, in the prescriber's words. The only thing that belongs in a dose column on this site. See the dose log.

Concentration. How much drug is in each millilitre of a vial, printed on the label as, for example, milligrams per millilitre. The same dose is a different number of units at a different concentration, which is why the dose log's header records it.

Units. The marks on an insulin syringe. On a U-100 syringe, 100 units is 1 millilitre. Units measure volume, not drug; the concentration converts between them. The calculators site's dose unit converter shows the arithmetic.

Lot number. The batch identifier printed on a pen, vial or carton. Needed for any report about the product. See the supply tracker.

Expiry date. The manufacturer's date after which a product should not be used, on the assumption it was stored as labelled.

Beyond-use date. The pharmacy's date for a compounded preparation, after which it should not be used. Usually much shorter than a manufactured product's expiry, and specific to the pharmacy's process and container. See the pharmacy question list.

Sharps container. An FDA-cleared puncture-resistant container for used needles and pens. Household bins are not one.

On the pharmacy question list

Compounded drug. A medication prepared by a licensed pharmacist or physician for a patient, rather than manufactured under an FDA approval. The FDA does not verify the safety, effectiveness or quality of compounded drugs before they are marketed. Not interchangeable with a brand product.

503A pharmacy. A state-licensed pharmacy compounding for individual patients on prescriptions. State boards of pharmacy have primary day-to-day oversight; the FDA does surveillance and for-cause inspections. Not required to follow current good manufacturing practice.

503B outsourcing facility. A compounder registered with the FDA under section 503B, inspected by the FDA on a risk-based schedule, and required to follow current good manufacturing practice. The FDA publishes the list.

Certificate of analysis. A laboratory report on a specific lot: what was tested, how, with what result, and by whom. For an injectable, typically potency, sterility and endotoxin.

Active pharmaceutical ingredient. The drug substance itself, before it is made into a preparation. The pharmacy buys it from a supplier; the question list asks which.

Excipient. Anything in the vial that is not the active ingredient: buffers, preservatives, and in some compounded products an added second ingredient.

MedWatch. The FDA's programme for reporting adverse events and product problems, open to patients as well as clinicians.

On the prior authorization checklist and appeal letter

Prior authorization. A payer's requirement that a prescriber obtain approval before a drug is covered. See the checklist.

Formulary. The list of drugs a plan covers, with tiers. A drug absent from the formulary is excluded rather than denied, and the route is an exception request.

Comorbidity. A condition present alongside the one being treated. Payers list which weight-related ones qualify, and the lists vary.

Letter of medical necessity. A prescriber's signed letter explaining why a treatment is needed for a specific patient. Separate from, and enclosed with, the member's appeal letter.

Internal appeal. A request that the plan reconsider its own denial. HealthCare.gov describes a 180-day window from the denial notice to file.

External review. A review of a final internal denial by someone outside the plan: a state process, the federal HHS process, or an independent review organisation. Requested within 4 months of the final denial; decided within 45 days, or 72 hours when expedited.

Expedited. Faster handling because a delay would seriously jeopardise health. Both appeal stages have an expedited track.

On the trackers and planners

Adequate intake. A National Academies intake level used when the evidence does not support a formal recommended allowance; the water and fibre figures on the hydration tracker are adequate intakes.

Recommended Dietary Allowance. The National Academies' intake level judged to meet the needs of nearly all healthy people in a group; the protein figure of 0.8 g per kg per day on the meal planner is one.

Waist circumference. The measurement around the middle just above the hip bones, after breathing out, in the NHLBI method. See the weight and waist tracker.

Change from start. Current value minus the value in the header, with sign. Divide by the start value and multiply by 100 for a percentage.

On the maintenance checklist

Randomised withdrawal trial. A design in which everyone receives the treatment first, and those who respond are then randomly assigned to continue it or switch to placebo. SURMOUNT-4 and STEP 4 are both this design. See the maintenance transition checklist.

Lead-in or run-in. The open-label period before randomisation: 36 weeks in SURMOUNT-4, 20 weeks in STEP 4.

Placebo. An inactive injection identical in appearance, given so that neither participant nor investigator knows who is on the drug.

Mean percent change. The average across a group of each person's weight change expressed as a percentage of their starting weight. A mean says nothing about any individual in the group.

Confidence interval. The range within which the true average difference is likely to lie given the trial's size; the trial reports quote one for each headline figure.