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We believe more prospectively collected data from multiple centres were essential to test our results.
Although multiple centres were involved most of these were specialist, and recruitment was unequally distributed, introducing a risk of geographical or centre-specific bias.
Access to continuing education and the possibility of receiving training delivered by multiple centres were the main perceived benefits for both recruitment and retention.
Multiple centres were required for this study, since enrolling the planned number of LT patients with HCC could only be accomplished through a broad-based concerted effort.
Presentation blood or bone marrow samples from multiple centres were obtained at diagnosis from patients with AML (excluding M3 subtype) and taken into preservative-free heparin or into EDTA tubes.
Finally, although multiple centres were included in this study, more than one-half of the patients were enrolled from two ICUs with small numbers included from some sites, limiting the ability to assess inter-facility variability.
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In general, large studies involving multiple centres are more feasible if they require minimal changes from current practice.
Further studies, ideally from multiple centres, are required to further define the precision and feasibility for this protocol.
We also excluded any trials where data on the date recruitment started, the disease site, the funding source or whether it had been conducted at a single centre or multiple centres was missing (n=54).
It is clear that collaboration across multiple disciplines and multiple centres is required to achieve the necessary progress outlined in the sections 'Primary studies of progostic markers' and 'Systematic reviews and meta-analysis'.
Given that existing processes of care will differ between centres, pilot studies in multiple centres are preferable, particularly to ensure that a multi-centre trial is feasible in both academic (for example, tertiary referral) and non-academic (for example, community and rural) hospitals.
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