Randomised controlled trials of complex interventions and large-scale transformation of services

Barratt, H., Campbell, M., Moore, L. , Zwarenstein, M. and Bower, P. (2016) Randomised controlled trials of complex interventions and large-scale transformation of services. Health Services and Delivery Research, 4(16), (doi:10.3310/hsdr04160-19)

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Abstract

Complex interventions and large-scale transformations of services are necessary to meet the health-care challenges of the 21st century. However, the evaluation of these types of interventions is challenging and requires methodological development. Innovations such as cluster randomised controlled trials, stepped-wedge designs, and non-randomised evaluations provide options to meet the needs of decision-makers. Adoption of theory and logic models can help clarify causal assumptions, and process evaluation can assist in understanding delivery in context. Issues of implementation must also be considered throughout intervention design and evaluation to ensure that results can be scaled for population benefit. Relevance requires evaluations conducted under real-world conditions, which in turn requires a pragmatic attitude to design. The increasing complexity of interventions and evaluations threatens the ability of researchers to meet the needs of decision-makers for rapid results. Improvements in efficiency are thus crucial, with electronic health records offering significant potential.

Item Type:Articles
Additional Information:
Raine R, Fitzpatrick R, Barratt H, Bevan G, Black N, Boaden R, et al. Challenges, solutions and future directions in the evaluation of service innovations in health care and public health. Health Serv Deliv Res 2016;4(16)

Essay 2.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Moore, Professor Laurence
Authors: Barratt, H., Campbell, M., Moore, L., Zwarenstein, M., and Bower, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO Unit
Journal Name:Health Services and Delivery Research
Publisher:NIHR Journals Library
ISSN:2050-4349
ISSN (Online):2050-4357
Copyright Holders:Copyright © 2016 Queen's Printer and Controller of HMSO
First Published:First published in Health Services and Delivery Research 4(16)
Publisher Policy:Reproduced in accordance with the publisher copyright policy
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727661SPHSU Core Renewal: Complexity in Health Improvement Research ProgrammeLaurence MooreMedical Research Council (MRC)MC_UU_12017/14IHW - MRC/CSO SPHU