Presentation at a joint seminar day for occupational therapy, physiotherapy and nursing at Umeå University, Sweden.
(Credits to professor David Richards, University of Exeter, for his enthusiasm and inspiration at the Summer Schools of the European Academy of Nursing.)
3. Background and history First MRC paper from 2000 Updated in 2008 (937 citations) (200 citations)
4. Examples Rehabilitation units for stroke patients Self-study to decrease disturbing behaviour among people with learning disabilities Community prevention of heart disease Group psychotherapy Patient education A clinical drug trial
5. Where is the complexityin a complex intervention? Takes place in a naturalistic setting Several... components behaviours possible outcomes levels of the health care system Heterogeneous population Almost always needs tailoring
21. Choosing theoptimal design Don’t just go for the most common design in your field! Always consider randomisation! Always consider experimental designs! Usual treatment rather than placebo
22. Measuring outcomes A step away from “primary outcome” What variation is there in outcomes... Between individuals Between sites Over time And what causes the variation?
26. Conclusion:why would we need this? Evidence-based practice Complexity is no reason for not evaluating Focus on practical effectiveness Implementation in practice is emphasized
27. The MRC guidance Short executive summary All steps described Lots of questions to ask yourself 14 case studies 161 references