The study is based on data collected from selected referral centres located in the capital cities of eight west African countries which typically have a concentrated level of the most difficult TB cases, including MDR-TB.
We selected referral rate (RR) to specialist care as the principal outcome measure because such referrals are easily and objectively measurable.
Gaitini et al. [19] found that routine referral of adult patients with clinical suspicion of acute appendicitis to color Doppler US and selected referral to CT based on US results and clinical judgment improved diagnostic accuracy and therapeutic management.
Positive ELISA results are confirmed by Western blot test performed in selected referral laboratories.
However, the selected referral hospital is generally well-known for its good service.
In selected referral hospitals in Jakarta, half of maternal deaths were related to inappropriate care by first providers (mainly midwives and TBAs) [ 34].
Six union councils in Dadu district and seven in Khanewal closest to the selected referral health facilities were included in the study to meet the required sample size.
The median overall survival from initial STS diagnosis was 4.8 years (95% CI, 3.6 5.6) in this highly selected referral center population of patients with metastatic/relapsed STS.
Recruitment of cases (to The UK Genetic Prostate Cancer Study; UKGPCS) was through notification by consultants and selected referral centres to the Institute of Cancer Research and The Royal Marsden NHS Foundation Trust.
However, clinical cohorts from selected referral centers do not assess real-life conditions found in busy, understaffed public health clinics scattered all over Brazil, a country where social and regional heterogeneities are very relevant in the field of AIDS care [ 19, 20], as well as health care in a broad sense [ 21].
