Studies assessing the effect of interventions to decrease variation in colonoscopy quality have shown inconsistent results.
Further evaluation of provider characteristics, referral patterns, and related health system processes should be undertaken to inform targeted interventions to reduce variation from recommended care.
Finally, a single determination of PAOP was performed since we attempted no intervention to induce variations in LV loading conditions.
To evaluate the impact of uncertainty around epidemiological parameters on predicted outcomes, we analyzed the sensitivity and elasticity of intervention effectiveness to variation in epidemiological parameters (Fig. 4).
We also conducted a series of simulations to determine the sensitivity of intervention measures to variation in key model parameters, including the degree of compliance, with results presented in the Supporting Information Text S2.
Reliability is an important dimension of any patient-based outcome measure as it is essential to establish whether changes observed are due to the intervention and not to variations related to problems with the outcome instrument.
Since community responses, including lifestyle changes, are shaped by sociocultural aspects and health system factors, effective mitigation of NCDs will therefore have to integrate community-based and individually targeted interventions (79) that are sensitive to variations in gender and cultural norms, for them to be acceptable (80).
Although the narrative synthesis allowed for a thorough discussion on the effectiveness of the interventions, a meta-analysis was not feasible for making estimates of strength of effect due to variations in intervention components, outcome measures, follow up times and study quality among the selected studies.
When intervention delivery is subject to variation, it is important to state whether the same individuals will deliver the trial interventions in all study groups, or whether different individuals will manage each study group—in which case it can be difficult to separate the effect of the intervention from that of the individual delivering it.
We will consider the feasibility of more explicit application of these theoretical frameworks to future interventions and to understanding variation in the success of our current interventions.
