Ultimately, despite its known limitations, [ 42] CAMS followed in the footsteps of other large pediatric comparative treatment trials and chose an unbalanced 1 × 4 parallel groups design because it represented the best compromise between ecological validity, feasibility of implementation, scientific rigor, and cost.
In the case of CAMS, the design chosen represented the best balance between scientific rigor, potential for public health impact, ecological validity, feasibility of implementation, and cost.
The methodological quality with respect to the rigor of development and implementation of current osteoporosis guidelines is low, although their scores with respect to clinical content are higher.
Because only a small percentage of the chosen operations presented complex predicates, we cannot conclude that differences of rigor between the implementation of the different criteria always follows theoretical expectations.
Exploring differences in study results as a function of differences in methodological rigor and/or implementation quality of the original studies could contribute to the current discussion of how best to perform SRs of interventions in community settings.
It includes managing the establishment of a national health research management forum; national, institutional and hospital ethical review committees to protect the dignity, integrity and safety of research participants; national and institutional scientific review committees to ensure scientific rigor of research protocols and their implementation; and the national network for R4H.
Unfortunately to date, efforts to implement quality improvement (QI) research findings into practice have often proceeded without insistence on the same level of rigor required to establish these QI targets as worthy of implementation [ 4].
A detail of implementation, I would say.
It's a matter of implementation.
But the challenge of implementation remains.
