Slides

Here are two examples showing the relationship between setting and applicability.

In the first example, the benefits of breast self-examinations are being evaluated in Shanghai and St. Petersburg. However, in China and Russia, the use of other more-sensitive breast cancer-detection methods such as mammography is minimal. Without another method to detect breast cancer, these studies may overemphasize the value of breast self-examinations.

In the second example, it is known that hospitals performing large numbers of abdominal aortic aneurysm repair surgeries have lower short-term mortality rates. Thus, when evaluating studies comparing complication rates between surgical repair and other therapies, the setting where the studies take place is very important in determining applicability.