We also cannot comment on the influence of unstudied respondent factors, such as ethnicity and religious affiliation, which might affect recommendations to limit aggressive care [ 31].
In a national survey of physicians with experience treating sepsis, we used simulated clinical vignettes to measure physician predictions about outcomes from septic shock, to test the influence of selected patient factors on these predictions and to determine how these factors and predictions affect recommendations for limitation of care.
New standardized measures for the assessment of suicidal behavior and ideation have been designed to improve identification and clinical management and have recently been effectively disseminated, which may affect recommendations in future guidelines [ 6].
The pandemic vaccine not only raises neutralization antibodies to cognate H1N1, but also elicits broadly heterosubtypic neutralization responses the implications of which would affect recommendations regarding the composition of influenza vaccine immunogens.
Conflicts of interest affect recommendations in clinical guidelines and disclosure of such conflicts is important.
A detailed understanding of meningococcal disease in communities will affect recommendations for current or future vaccines or other prevention strategies.
Qualitative analysis of the updating process and how new evidence is incorporated and affects recommendations should also be taken into account in assessing whether one summary is better than others.
For instance, gender [10], [13], status [13] and an author's country of affiliation [11], [12] have been demonstrated to affect the referee recommendation to publish or reject a given manuscript [1], [3], [14].
Doctors only explain the details of the questionnaire to let the patient fully understand questions without any personal recommendations to affect selection.
Until we have an appropriate grasp on the underlying meaning of the variability of these measures and the factors effecting their measurement, we cannot make conclusive or useful recommendations to affect these measures for the sake of disease prevention or treatment efforts.
