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Research designs for studies evaluating the effectiveness of change and improvement strategies

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Eccles, M·2003·Quality and Safety in Health Care

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Abstract

The methods of evaluating change and improvement strategies are not well described. The design and conduct of a range of experimental and non-experimental quantitative designs are considered. Such study designs should usually be used in a context where they build on appropriate theoretical, qualitative and modelling work, particularly in the development of appropriate interventions. A range of experimental designs are discussed including single and multiple arm randomised controlled trials and the use of more complex factorial and block designs. The impact of randomisation at both group and individual levels and three non-experimental designs (uncontrolled before and after, controlled before and after, and time series analysis) are also considered. The design chosen will reflect both the needs (and resources) in any particular circumstances and also the purpose of the evaluation. The general principle underlying the choice of evaluative design is, however, simple-those conducting such evaluations should use the most robust design possible to minimise bias and maximise generalisability.

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Authors: Eccles, M.
Affiliations: Newcastle University (GB)
Corresponding author: Eccles, M
ORCID: Eccles, M
Venue: Quality and Safety in Health Care
Publisher: BMJ
Published: 2003-02-01
Volume: 12
Issue: 1
Pages: 47-52
ISSN: 1475-3898 (ISSN-L)
1475-3901
DOI: 10.1136/qhc.12.1.47
PMC: PMC1743658
OpenAlex: W2046947214
Cited by: 586
References: 24
Citations by year: 2026: 8 · 2025: 11 · 2024: 16 · 2023: 21 · 2022: 16 · 2021: 24 · 2020: 34 · 2019: 44 · 2018: 31 · 2017: 40 · 2016: 35 · 2015: 44 · 2014: 32 · 2013: 24 · 2012: 23
FWCI: 35.41
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: other-oa
Locations: BMJ Quality & Safety (publishedVersion, other-oa)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Newcastle University
University of Aberdeen
Topics: Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Social Sciences › Public Administration › Evaluation and Performance Assessment
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Quality and Management
Keywords: research design, improvement measures, randomized controlled trials, factorial design, block designs, before-after study, time series analysis, bias, generalizability, intervention development
MeSH terms: United Kingdom, Health Services Research, Humans, Organizational Innovation, Research Design, State Medicine, Reproducibility of Results, Program Evaluation, Cluster Analysis, Randomized Controlled Trials as Topic, Total Quality Management

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