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While control measures by regulations and enforcement by the government officials exist for counterfeit and substandard medicines, the implementation of these control measures is imperfect.
The rate of increased incidence of substandard medicines could be associated with the implementation of improved detection policies and regulations by Health Canada.
Usually, quarterly to six-monthly analysis of audit systems is recommended for evaluation of recurrence of substandard care factors and the success of implementation of the recommendations [ 30].
The CONSORT statement was established in 1996 and the speed of implementation of the guideline from the CONSORT group has been substandard as there continue to be observational studies concluding inadequate quality of reporting of many RCTs dated from 1996 till now [ 1, 17, 21, 23- 25].
This is a major step-up over implementation studies, which showed a benefit of tight glycaemic control but are substandard to assess effectiveness of a therapy [ 4].
The perinatal audit resulted in description of substandard factors (SSF), relation to death and the formulation of many recommendations mostly ready for implementation.
Substandard schools?
Housing is often substandard.
Their medical is substandard.
Temporary, substandard grass fields?
Sometimes, they were also substandard.
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