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Further study is warranted to determine the extent to which onset age should be used in the international context as a defining characteristic for more homogenous subgroups within bipolar disorder.
These more homogenous subgroups of cases might have a more common etiology that could potentially be detected in cluster analysis.
The Asian genomes of the four serotypes showed a wide diversity in the clusters and each of them can be further divided into more homogenous subgroups.
Future research should focus on refinement of tumor subtypes into more homogenous subgroups in order to best elucidate how risk factors may vary by subtype.
Clinical heterogeneity of participants in clinical trials is hypothesised as reducing the likelihood of demonstrating treatment effects, and sampling of more homogenous subgroups is recommended.
Our results also show that there is a considerable heterogeneity within the clusters and each of the clusters can be divided further to more homogenous subgroups.
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Deficit syndrome, which is proposed to identify a putatively more homogenous subgroup in schizophrenia, highlights the manifestation of prominent, primary and enduring negative symptoms that are resistant to treatment.
This is supported by the finding of a higher risk of revision due to infection in 2005 2009 than in 1995 1999 both for the uncemented THAs, which were all modular, and for the more homogenous subgroup of modular THAs inserted with cement containing antibiotics in patients with OA.
For studies using inbred mouse lines, a cladogram which is a hierarchical grouping based on phylogenetic analysis of strain relatedness can be created to subdivide inbred strains into more genetically homogenous subgroups.
Analyses of smaller, more clinically homogenous subgroups (e.g., nonlesional focal epilepsies), in which family studies show a stronger genetic influence (Ottman et al., 1996a) may reveal associations masked by the clinical heterogeneity in both of these studies.
Such an approach would also have implications about the delineation of heterogeneous complex genetic diseases with high heritability (e.g. schizophrenia [ 51- 54]) into more homogenous endophenotypes based on subgroups of patients present in the database.
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