308 research outputs found
Yes, research can inform health policy; but can we bridge the 'Do-Knowing It's Been Done' gap?
No full textCopyright @ 2011 Hanney and Gonzalez.Provisional Abstract: This editorial introduces a new Supplement in Health Research Policy and Systems and highlighs the importance of assessing the impact of health research by examining whether we can move from 'Know-Do' to 'Do-Knowing It's Been Done'This article is made available through the Brunel Open Access publishing fund
Assessing the impact of England's National Health Service R&D Health Technology Assessment program using the "payback" approach
No full textCopyright © Cambridge University Press 2009Objectives: This study assesses the impact of the English National Health Service (NHS) Health Technology Assessment (HTA) program using the "payback" framework.Methods: A survey of lead investigators of all research projects funded by the HTA program 1993-2003 supplemented by more detailed case studies of sixteen projects.Results: Of 204 eligible projects, replies were received from 133 or 65 percent. The mean number of peer-reviewed publications per project was 2.9. Seventy-three percent of projects claimed to have had had an impact on policy and 42 percent on behavior. Technology Assessment Reports for the National Institute for Health and Clinical Excellence (NICE) had fewer than average publications but greater impact on policy. Half of all projects went on to secure further funding. The case studies confirmed the survey findings and indicated factors associated with impact.Conclusions: The HTA program performed relatively well in terms of "payback." Facilitating factors included the program's emphasis on topics that matter to the NHS, rigorous methods and the existence of "policy customers" such as NICE
Conducting retrospective impact analysis to inform a medical research charity’s funding strategies: The case of Asthma UK
No full text© 2013 Hanney et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This article has been made available through the Brunel Open Access Publishing Fund.BACKGROUND: Debate is intensifying about how to assess the full range of impacts from medical research. Complexity increases when assessing the diverse funding streams of funders such as Asthma UK, a charitable patient organisation supporting medical research to benefit people with asthma. This paper aims to describe the various impacts identified from a range of Asthma UK research, and explore how Asthma UK utilised the characteristics of successful funding approaches to inform future research strategies. METHODS: We adapted the Payback Framework, using it both in a survey and to help structure interviews, documentary analysis, and case studies. We sent surveys to 153 lead researchers of projects, plus 10 past research fellows, and also conducted 14 detailed case studies. These covered nine projects and two fellowships, in addition to the innovative case studies on the professorial chairs (funded since 1988) and the MRC-Asthma UK Centre in Allergic Mechanisms of Asthma (the ‘Centre’) which together facilitated a comprehensive analysis of the whole funding portfolio. We organised each case study to capture whatever academic and wider societal impacts (or payback) might have arisen given the diverse timescales, size of funding involved, and extent to which Asthma UK funding contributed to the impacts. RESULTS: Projects recorded an average of four peer-reviewed journal articles. Together the chairs reported over 500 papers. All streams of funding attracted follow-on funding. Each of the various categories of societal impacts arose from only a minority of individual projects and fellowships. Some of the research portfolio is influencing asthma-related clinical guidelines, and some contributing to product development. The latter includes potentially major breakthroughs in asthma therapies (in immunotherapy, and new inhaled drugs) trialled by university spin-out companies. Such research-informed guidelines and medicines can, in turn, contribute to health improvements. The role of the chairs and the pioneering collaborative Centre is shown as being particularly important. CONCLUSIONS: We systematically demonstrate that all types of Asthma UK’s research funding assessed are making impacts at different levels, but the main societal impacts from projects and fellowships come from a minority of those funded. Asthma UK used the study’s findings, especially in relation to the Centre, to inform research funding strategies to promote the achievement of impact.This study was funded by Asthma UK
The “Payback Framework” explained
No full textThe Payback Framework, originally developed to examine the ‘impact ’ or ‘payback ’ of health services research, is explained. The Payback Framework is a research tool used to facilitate data collection and cross-case analysis by providing a common structure and so ensuring cognate information is recorded. It consists of a logic model representation of the complete research process, and a series of categories to classify the individual paybacks from research. Its multi-dimensional categorisation of benefits from research starts with more traditional academic benefits of knowledge production and research capacity-building, and then extends to wider benefits to society. HE PAYBACK FRAMEWORK was original-ly developed by Martin Buxton and Stephen Hanney at the Health Economics Research Group (HERG) at Brunel University, UK, to exam-ine the ‘impact ’ or ‘payback ’ of health services re-search (Buxton and Hanney, 1994; 1996). It was further developed in studies of research funded by the National Health Service (NHS) (Buxton an
Engagement in research: An innovative three stage review of the benefits for health-care performance
No full text© Queen's Printer and Controller of HMSO 2013. This work was produced by Hanney et al. under the terms of a commissioning
contract issued by the Secretary of State for Health. This issue may be freely reproduced for the purposes of private research and
study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement
is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be
addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre,
Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.Background - There is a widely held assumption that research engagement improves health-care performance at various levels, but little direct empirical evidence.
Objectives - To conduct a theoretically and empirically grounded synthesis to map and explore plausible mechanisms through which research engagement might improve health services performance. A review of the effects on patients of their health-care practitioner's or institution's participation in clinical trials was published after submission of the proposal for this review. It identified only 13 relevant papers and, overall, suggested that the evidence that research engagement improves health-care performance was less strong than some thought. We aimed to meet the need for a wider review.
Methods - An hourglass review was developed, consisting of three stages: (1) a planning and mapping stage; (2) a focused review concentrating on the core question of whether or not research engagement improves health care; and (3) a wider (but less systematic) review of papers identified during the two earlier stages. Studies were included in the focused review if the concept of ‘engagement in research’ was an input and some measure of ‘performance’ an output. The search strategy covered the period 1990 to March 2012. MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science and other relevant databases were searched. A total of 10,239 papers were identified through the database searches, and 159 from other sources. A further relevance and quality check on 473 papers was undertaken, and identified 33 papers for inclusion in the review. A standard meta-analysis was not possible on the heterogeneous mix of papers in the focused review. Therefore an explanatory matrix was developed to help characterise the circumstances in which research engagement might improve health-care performance and the mechanisms that might be at work, identifying two main dimensions along which to categorise the studies: the degree of intentionality and the scope of the impact.
Results - Of the 33 papers in the focused review, 28 were positive (of which six were positive/mixed) in relation to the question of whether or not research engagement improves health-care performance. Five papers were negative (of which two were negative/mixed). Seven out of 28 positive papers reported some improvement in health outcomes. For the rest, the improved care took the form of improved processes of care. Nine positive papers were at a clinician level and 19 at an institutional level. The wider review demonstrated, for example, how collaborative and action research can encourage some progress along the pathway from research engagement towards improved health-care performance. There is also evidence that organisations in which the research function is fully integrated into the organisational structure out-perform other organisations that pay less formal heed to research and its outputs. The focused and wider reviews identified the diversity in the mechanisms through which research engagement might improve health care: there are many circumstances and mechanisms at work, more than one mechanism is often operative, and the evidence available for each one is limited.
Limitations - To address the complexities of this evidence synthesis of research we needed to spend significant time mapping the literature, and narrowed the research question to make it feasible. We excluded many potentially relevant papers (though we partially addressed this by conducting a wider additional synthesis). Studies assessing the impact made on clinician behaviour by small, locally conducted pieces of research could be difficult to interpret without full knowledge of the context.
Conclusions - Drawing on the focused and wider reviews, it is suggested that when clinicians and health-care organisations engage in research there is the likelihood of a positive impact on health-care performance. Organisations that have deliberately integrated the research function into organisational structures demonstrate how research engagement can, among other factors, contribute to improved health-care performance. Further explorations are required of research networks and schemes to promote the engagement of clinicians and managers in research. Detailed observational research focusing on research engagement within organisations would build up an understanding of mechanisms.National Institute for Health Researc
Who needs what from a national health research system: Lessons from reforms to the English Department of Health's R&D system
No full textThis article has been made available through the Brunel Open Access Publishing Fund.Health research systems consist of diverse groups who have some role in health research, but the boundaries around such a system are not clear-cut. To explore what various stakeholders need we reviewed the literature including that on the history of English health R&D reforms, and we also applied some relevant conceptual frameworks.
We first describe the needs and capabilities of the main groups of stakeholders in health research systems, and explain key features of policymaking systems within which these stakeholders operate in the UK. The five groups are policymakers (and health care managers), health professionals, patients and the general public, industry, and researchers. As individuals and as organisations they have a range of needs from the health research system, but should also develop specific capabilities in order to contribute effectively to the system and benefit from it.
Second, we discuss key phases of reform in the development of the English health research system over four decades -
especially that of the English Department of Health's R&D system - and identify how far legitimate demands of key stakeholder interests were addressed.
Third, in drawing lessons we highlight points emerging from contemporary reports, but also attempt to identify issues through application of relevant conceptual frameworks. The main lessons are: the importance of comprehensively addressing the diverse needs of various interacting institutions and stakeholders; the desirability of developing facilitating mechanisms at interfaces between the health research system and its various stakeholders; and the importance of additional money in being able to expand the scope of the health research system whilst maintaining support for basic science.
We conclude that the latest health R&D strategy in England builds on recent progress and tackles acknowledged weaknesses. The strategy goes a considerable way to identifying and more effectively meeting the needs of key groups such as medical academics, patients and industry, and has been remarkably successful in increasing the funding for health research. There are still areas that might benefit from further recognition and resourcing, but the lessons identified, and progress made by the reforms are relevant for the design and coordination of national health research systems beyond England.This article is available through the Brunel Open Access Publishing Fund
Lessons from the evaluation of the UK's NHS R&D Implementation Methods Programme
No full textBackground: Concern about the effective use of research was a major factor behind the creation
of the NHS R&D Programme in 1991. In 1994, an advisory group was established to identify
research priorities in research implementation. The Implementation Methods Programme (IMP)
flowed from this, and its commissioning group funded 36 projects. In 2000 responsibility for the
programme passed to the National Co-ordinating Centre for NHS Service Delivery and
Organisation R&D, which asked the Health Economics Research Group (HERG), Brunel University,
to conduct an evaluation in 2002. By then most projects had been completed. This evaluation was
intended to cover: the quality of outputs, lessons to be learnt about the communication strategy
and the commissioning process, and the benefits from the projects.
Methods: We adopted a wide range of quantitative and qualitative methods. They included:
documentary analysis, interviews with key actors, questionnaires to the funded lead researchers,
questionnaires to potential users, and desk analysis.
Results: Quantitative assessment of outputs and dissemination revealed that the IMP funded useful
research projects, some of which had considerable impact against the various categories in the
HERG payback model, such as publications, further research, research training, impact on health
policy, and clinical practice.
Qualitative findings from interviews with advisory and commissioning group members indicated
that when the IMP was established, implementation research was a relatively unexplored field. This
was reflected in the understanding brought to their roles by members of the advisory and
commissioning groups, in the way priorities for research were chosen and developed, and in how
the research projects were commissioned. The ideological and methodological debates associated
with these decisions have continued among those working in this field. The need for an effective
communication strategy for the programme as a whole was particularly important. However, such
a strategy was never developed, making it difficult to establish the general influence of the IMP as a
programme.
Conclusion: Our findings about the impact of the work funded, and the difficulties faced by those
developing the IMP, have implications for the development of strategic programmes of research in
general, as well as for the development of more effective research in this field
Global IDEA
No full textFive members of the Global IDEA Scientific Advisory Committee respond to Dr. Moore and colleagues: Global IDEA Scientific Advisory Committee. Health and economic benefits of an accelerated program of research to combat global infectious diseases
Project Retrosight. Understanding the returns from cardiovascular and stroke research: Case Studies
No full textCopyright @ 2011 RAND Europe. All rights reserved. The full text article is available via the link below.This project explores the impacts arising from cardiovascular and stroke research funded 15-20 years ago and attempts to draw out aspects of the research, researcher or environment that are associated with high or low impact. The project is a case study-based review of 29 cardiovascular and stroke research grants, funded in Australia, Canada and UK between 1989 and 1993. The case studies focused on the individual grants but considered the development of the investigators and ideas involved in the research projects from initiation to the present day. Grants were selected through a stratified random selection approach that aimed to include both high- and low-impact grants. The key messages are as follows: 1) The cases reveal that a large and diverse range of impacts arose from the 29 grants studied. 2) There are variations between the impacts derived from basic biomedical and clinical research. 3) There is no correlation between knowledge production and wider impacts 4) The majority of economic impacts identified come from a minority of projects. 5) We identified factors that appear to be associated with high and low impact. This report presents the key observations of the study and an overview of the methods involved. It has been written for funders of biomedical and health research and health services, health researchers, and policy makers in those fields. It will also be of interest to those involved in research and impact evaluation.This study was initiated with internal funding from RAND Europe and HERG, with continuing funding from the UK National Institute for Health Research, the Canadian Institutes of Health Research, the Heart and Stroke Foundation of Canada and the National Heart Foundation of Australia. The UK Stroke Association and the British Heart Foundation provided support in kind through access to their archives
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