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Based on recent modelling work [3], we hypothesised that this could be due to difference in standards of administering treatment at the centres, differences in the frequency of monitoring patients or variation in the profile of patients entering care (age and CD4 cell count when first presenting).
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The used (paper-based) protocol was often not extensively tested before implementation, and adherence to it was not reported or registered, a fact that may be especially problematic in a multi-center approach where different sites often display substantial differences in standards of critical care including important aspects in nutrition and glycemic control.
Any future trial will need to account for differences in standards of practice for severe sepsis in different regions of the world [ 15, 16].
But it is genuinely democratic, while recognising differences in standards of creativity and of response.
But the survey does suggest that differences in standards of living in the euro area may not be as great as they are often assumed to be.
This is partly due to geographic and climatic conditions, but, more important, it is also due to differences in standards of hygiene and the availability of medical care.
Key concerns in all trials regarded potential confounding factors including variations in patient characteristics, Ebola virulence on presentation, and differences in standards of supportive care over time.
Though there may not be differences in standards of medical ethics across sociocultural contexts [ 6], competing ethical principles may influence research practices and implementation.
To reduce the differences in standards of care between countries and institutions, each participating trauma center had to develop specific transfusion guidelines in line with the transfusion guidelines provided in the study protocol.
Even ratings of very specific functions ("difficulty lifting your arm over your head") may be affected by individual differences in standards of comparison ("compared with how I used to be?" or "compared to my mom after she had the same surgery?") and salience ("how often do I really need to lift my arm like that?").
There were limitations to this study including small sample size across different sites, the mandated use of ultrasound in Senegal, and the differences in standard of care at each location.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com