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While marked by a large sample size and echocardiography performed during the early phase of sepsis most relevant to therapeutic interventions, our study nevertheless has limitations.
Based on the new Medical Research Council guidance on complex interventions, our study can be regarded as an evaluation study [ 19].
Although this study was not designed to evaluate specific interventions, our study period and population-based sample can provide an ecologic assessment of changing beliefs.
In addition to the implications for chemotherapeutic interventions, our study supports the notion that the ability to up-regulate these defences in response to stress is important for longevity.
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In addition to the impact of the intervention, our study evaluated the process of the intervention and ventured to understand factors affecting the intended outcomes of the intervention.
However, though we consider that it is a key element in the intervention, our study does not allow us to evaluate the different components of the intervention independently.
Firstly, unlike previous observational studies examining the risk of acute kidney injury and subsequent clinical outcomes in the setting of percutaneous coronary intervention, our study enrolled all people with acute coronary syndrome within a geographical region.
While other interventions are also important in reducing the burden of disease and costs attributable to diarrhoea, such as staff hand-washing that was also promoted within the intervention, our study design did not allow us to evaluate any effect of the intervention on these practices.
We have no specific information on such interventions in our study population and therefore were unable to incorporate treatment interventions into our analysis.
The comparison of the two interventions in our study may lead to some methodological difficulties because of the different length of both interventions.
Finally, we excluded patients undergoing peripheral vascular interventions, EVAR or neuro-interventions from our study for reasons explained above.
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CEO of Professional Science Editing for Scientists @ prosciediting.com