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Standardisation of technique and interobserver reproducibility will need to be addressed.
Twelve specific challenges were highlighted: standardisation of technique; pilot and feasibility studies; balancing treatments; the recruitment pathway; outcome measures; patient and public representation; trainee-led networks; randomisation; novel techniques and training; learning curves; blinding; follow-up.
Participating surgeons perform over 100 hip arthroscopies each year and will meet prior to commencing recruitment to ensure standardisation of technique.
There are some conflicting reports suggesting that lymphadenectomy confers no survival benefit (Hulscher et al, 2001) however such studies are either too small with insufficient statistical power, not stratified by tumour stage or lack standardisation of technique.
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It is concluded that sheep visual acuity is potentially greater than hitherto realised, but that standardisation of techniques is required to make accurate comparisons with data gathered previously.
7 9 The level of standardisation of techniques used to analyse patient complaints is unclear, and there may be benefit in developing a standardised and reliable taxonomy for analysing and interpreting (in terms of patient safety) complaint data.
To achieve such a general approach, it is indispensable to adhere to the standardisation of techniques, to intensify collaborations between different expert groups, to share array data as raw data and to define guidelines of good scientific practice to respect and honour individual contributions to such databases, which must be made publicly accessible [ 44].
A method of quantifying the forces applied during examination would increase knowledge of 'normal' laxity, allow standardisation of examination technique and permit comparison of surgical results between practitioners.
In spite of advanced expertise in fibrooptic upper tract endoscopy, issues with ureteroscopic biopsies such as suboptimal tissue volume, poor quality, lack of standardisation of biopsy technique, and type of preservative for storage of specimen remain unresolved.
The number of publications describing the use of viscoelastic methodology is rapidly increasing; however, the methods employed by different investigators differ significantly, highlighting a need for standardisation of the technique [ 154, 155].
Hazard ratio was also significant for the studies using RT PCR and not for those using IHC, suggesting that a better standardisation of the technique to define and to detect COX-2 positivity is required to the generalisability of the results.
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