We hypothesize that the stringent criteria for confirmation of a human case of H5N1 by WHO do not account for a majority of infections but rather the select few hospitalized cases that are more likely to be severe and result in poor clinical outcome.
Our case definition for pulmonary embolism was relatively stringent and required confirmation in medical records.
The OMB guidelines explain that the standard they use, "capable of being substantially reproduced," is less stringent than a "confirmation" standard because it simply requires that an agency's analysis be sufficiently transparent that another qualified party could replicate it through reanalysis.
Additionally, we did not focus on single gene analysis, which would require much more stringent molecular and biochemical confirmation of the identified molecules.
We observed significant associations between DNA methylation at 11 different CpG loci representing 35 cis and 5 trans effects after stringent multiple testing correction and confirmation by permutation testing (Supplementary Table S4 shows all 106 methylation probes that showed significant associations after FDR correction for multiple testing, uncorrected for the 512 phenotypes tested).
Interestingly, surveillance systems with the most stringent outbreak criteria, including laboratory confirmation of outbreaks (England and Wales, Finland, and Sweden) ascertained the most outbreaks, likely because surveillance in these countries is more developed and integrated better with reporting bodies.
Using a more stringent threshold (<3.0 mmol/l) for confirmation of hypoglycaemia, a numerically greater reduction in the percentage of participants with, and event rate of, nocturnal hypoglycaemia with Gla-300 versus Gla-100 over 6 months was apparent.
They were shown to be statistically significant upon testing by stringent criteria (Table S4), and found confirmation in the lower diversity of the haplotypes containing the D-allele of rs1816072 (Figure 2, Figure 3 and Table S2).
Ghent-1 proposed more stringent clinical criteria, which led to the confirmation of MFS in only 32%53%% of patients formerly diagnosed with MFS according to the Berlin nosology.
