In the preliminary phase of the QC3 project shown in this paper, we developed a panel of evidence-based CRC QIs which are suitable for implementation in a population-based setting.
Given the comparatively low specificity of the tumour M2-PK test observed in our study, we deliberately discussed with caution whether its implementation in a population-based screening setting is justifiable, from both an ethical and an economic point of view.
We conducted a before and after protocol implementation study in a population of children aged 0 18 years who required mechanical ventilation for at least 24 h between January 2013 and March 2015.
Third, practitioners and managers were interviewed using convergent interviewing [ 26] to identify factors associated with success or failure of program implementation in a vulnerable population [ 27].
Recently, Rajajee and colleagues [ 18] demonstrated the feasibility of US guidance during the implementation of PCT in a population of neuro-intensive care patients.
Interventions of greater intensity, delivered at a different age, or both may yet prove helpful, although we recognise that this may put them out of the reach of implementation in the population.
Additional investigations will be necessary to evaluate how the quality of life of this group of adolescents might differ from our sample, although study design and implementation in this population will likely be challenging.
In particular, the present study is exploratory in nature, and precedes implementation of a population-based CRC screening program in the Balearic Islands.
Considering the current specificity, it is debatable whether implementation of this test in a population-based screening setting is justifiable, from both an ethical and an economic point of view.
After implementation of DiAlert in the ethnic Dutch population, we will assess effectiveness and feasibility of DiAlert in a population of Turkish people who live in the region of Amsterdam in the Netherlands.
