The impact of each of these issues on specific studies needs to be considered and, if possible, minimized.
Specific studies need to examine reasons for the observed differences and the influence of culture and beliefs.
Suitable reference genes for colorectal tissue-specific studies needs to be further assessed as previous reports have demonstrated that a single universal reference gene for all tissue types is unlikely to exist [ 19- 23].
More evidence-based guidelines for patient and surgeon preoperative preparation, ideally based on veterinary-specific studies, need to be established and implemented to help improve the standard of veterinary care and reduce preventable SSIs, while maintaining efficiency and cost-effectiveness.
Whether the SWD is the best design option for a specific intervention study needs to be decided by considering all, multidisciplinary (statistical, methodological, ethical and health economical) aspects in comparison to other feasible designs.
The suggested cut-off level at 17.5 cycles is calculated on this specific study population and needs further validation in other studies before it can be applicable in a clinical context.
Depending on the purpose of a specific study or the needs of PRO assessment in routine care, the MSSS-88 scale can be used together with other instruments assessing different aspects important for patients with MS, such as self management [ 48], functioning [ 37] and fatigue [ 35].
