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heterogeneous nature of the condition and because most data derive from case reports or case series from single centres-large case control studies and randomised controlled trials are scant.The International Collaboration on Endocarditis has been conceived recently to develop a large global database of patients whose clinical, echocardiographic, and microbiological findings have been characterised by using standard methodology.The associated network of investigators and organisational infrastructure will provide the platform for large randomised trials to test therapeutic strategies. 12This resource offers the opportunity for major advances in our understanding and treatment of infective endocarditis over the next two decades and provides a model on which global collaboration in other disease areas is likely to be based.