Although (as our analysis shows) low compliance with surveillance would have a relatively modest influence on cost-effectiveness, it would adversely impact on programme effectiveness.
Given the low compliance of the pulmonary interstitium, it is likely that even a modest increase in microvascular permeability leads to an increase in interstitial pressure that in turn causes a reversal of trans-endothelial pressure gradients for pulmonary capillaries.
If compliance is modest, the IV estimate is the local average treatment effect (Angrist and Pischke 2009).
Consistent with our study results, it has been shown in the literature that the majority of guideline implementation strategies do achieve modest improvements in guideline compliance [17].
Our data show significant improvement in outcomes even with modest increase in the compliance with the CVP and ScvO2 elements, supporting the notion that the key to improving sepsis outcome lies mainly in the early recognition, early fluid administration and early antibiotic therapy [48].
This simulation clearly shows that the metabolic benefit of 4 h of CPAP use, often considered as adequate CPAP compliance, is modest, while a much more clinically significant effect can be obtained when treatment is extended to 6 h and beyond.
However, our effects on inspiratory and driving pressures, as well as the compliance, were only modest.
Yet, many sepsis improvement projects invested in potentially low-leverage interventions leading to modest change in sepsis bundle compliance and mortality.
The E.P.A. also predicted that the costs of compliance would be relatively modest.
Indeed, the study by Westra and Dozois (2006) reported only a modest correlation between therapist and client compliance ratings.
