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As these changes were minor, the difference in guidelines from 2003 to 2013 does not have a significant effect the interpretation of the results.
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However, CHWs in Kenya, who reported to be selected by the community, did not show any difference in guideline adherence when compared to CHWs who reported no community involvement in selection (Rowe et al. 2007a).
The difference in guideline use was not statistically significant in intention-to-treat analysis (55% vs. 48%; p = 0.081), but was significant in per-protocol analysis, i.e., PTs who participated in the implementation seminar reported frequent use of guidelines to significantly greater extent than those in the control group (63% vs. 48%; p = 0.043).
Differences in guidelines, reflecting the differing views of individuals participating in the guideline development process, are therefore to be expected [ 29, 31].
Despite these groups, difficulties in international collaboration have emerged where there are differences in guidelines [ 10].
The observed differences in guidelines some times are due to scarce resources and in some instances are due to socio-cultural factors.
Reconciling differences in guidelines from the United Kingdom, Italy and Japan for the diagnosis and therapy of DIC was recommended in a recent publication [ 5].
Logistic regression analysis was conducted to evaluate differences in guideline adherence for male and female patients.
Differences in guideline recommendations are not sufficient to explain variation of prescribing among countries, thus other factors must be considered.
These differences in guideline adherence were mainly caused by significantly higher rates of guideline violations concerning chemotherapy in all the TNBC age groups (P < 0.001) (see Table 3).
The fact that we found large differences in guideline adherence between practices is also consistent with previous studies in diabetes care [ 17].
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