The DOI matches its Crossref record; 86 of the 87 references it cites were found in a registry or an index; none of the 41 sources its claims cite is checked for support yet.
Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health
Open accessAbstract
We present a vision of clinical science, based on a conceptual framework of intervention development endorsed by the Delaware Project. This framework is grounded in an updated stage model that incorporates basic science questions of mechanisms into every stage of clinical science research. The vision presented is intended to unify various aspects of clinical science toward the common goal of developing maximally potent and implementable interventions, while unveiling new avenues of science in which basic and applied goals are of equally high importance. Training in this integrated, translational model may help students learn how to conduct research in every domain of clinical science and at each stage of intervention development. This vision aims to propel the field to fulfill the public health goal of producing implementable and effective treatment and prevention interventions.
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Claims the paper makes
48 Own interpretation · 27 Not checked yet · 15 No basis given
None of the sources cited for this claim have been checked yet.
In the paper
“Several factors converge to create this widely acknowledged science-to-service gap, or what Weisz et al. (Weisz, Jensen-Doss, & Hawley, 2006; Weisz, Ng, & Bearman, 2014) call the implementation cliff.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Weisz, Jensen-Doss, & Hawley, 2006
- Not checked yetcites Weisz, Ng, & Bearman, 2014
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the absence of better understanding of how interventions work, efforts to adapt interventions (e.g., dose reduction), a common practice in community settings, may render the interventions devoid of their original efficacy.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Another example is the computerized attention modification program that directly targets cognitive biases operating in the most prevalent mood disorders (Amir & Taylor, 2012).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the Interventions: Adapting Square Pegs to Fit Into Round Holes
What the sources say
- Not checked yetcites Amir & Taylor, 2012
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“It is not reasonable to expect that a positive efficacy study will automatically or even usually lead to a positive effectiveness study (Flay, 1986).”
- Also stated in: § Concluding Remarks · hedged
“They need to expect that successful research setting–based efficacy trials are not likely to directly result in successful effectiveness trials”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage III
What the sources say
- Not checked yetcites Flay, 1986
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Concluding Remarks · hedged
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For such testing to occur, the intervention will likely need to be further developed or “adapted” for community providers.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Efficacy Testing in the Real-World Settings
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Immediately and directly proceeding from Stage II to Stage III is not a typical path within the stage model.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage III
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We argue that an understanding of change mechanisms is often critical for developing the most effective interventions that can be scaled up and trimmed down.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: unclear — It is unclear whether it could be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Adapting the intervention in response to practical constraints is an inherently risky endeavor: The intervention may or may not retain the elements that make it work.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the Interventions: Adapting Square Pegs to Fit Into Round Holes
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Moreover, community providers’ motivation and comfort level with empirically supported treatments is lower than that of research therapists (Stewart, Chambless, & Baron, 2012).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Stewart, Chambless, & Baron, 2012
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Often, community practitioners modify the intervention, including those participating in effectiveness studies of science-based interventions (Stewart, Stirman, & Chambless, 2012).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the Interventions: Adapting Square Pegs to Fit Into Round Holes
What the sources say
- Not checked yetcites Stewart, Stirman, & Chambless, 2012
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“If positive results have been obtained from a Stage II study, usually additional community-friendly Stage I work is needed to make the intervention ready for a Stage III trial.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage III
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Complex treatments delivered with high fidelity in research settings by research therapists tend to lose strength when delivered in community settings by community providers.
None of the sources cited for this claim have been checked yet.
In the paper
“To wit, only a small fraction of clinicians who routinely provide interventions such as cognitive behavioral therapy (CBT) are able to do so with adequate fidelity (Beidas & Kendall, 2010; Olmstead, Abraham, Martino, & Roman, 2012).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Beidas & Kendall, 2010
- Not checked yetcites Olmstead, Abraham, Martino, & Roman, 2012
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As noted, complex interventions administered with a high degree of fidelity in research settings with research providers seem destined to weaken when implemented in community settings with community providers.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Efficacy Testing in the Real-World Settings
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“For one, we can trace the implementation cliff back to the effect size drop evident in many effectiveness trials (Curtis, Ronan, & Borduin, 2004; Henggeler, 2004; Miller, 2005; Weisz, Weiss, & Donenberg, 1992).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Curtis, Ronan, & Borduin, 2004
- Not checked yetcites Henggeler, 2004
- Not checked yetcites Miller, 2005
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“A major factor that can explain this drop in effect size is treatment fidelity (also known as treatment integrity), which refers to the implementation of an intervention in a manner consistent with principles outlined in an established manual (Henggeler, 2011; Perepletchikova, Treat, & Kazdin, 2007).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Henggeler, 2011
- Not checked yetcites Perepletchikova, Treat, & Kazdin, 2007
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There is no similar incentive system for community therapists.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is entirely possible to develop highly potent, implementable interventions without understanding mechanisms of change.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
In the paper
“First, understanding mechanisms can guide the enhancement and simplification of interventions (Kazdin & Nock, 2003).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
What the sources say
- Not checked yetcites Kazdin & Nock, 2003
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“This strategy is particularly puzzling in light of the fact that so many efficacious behavioral interventions do not make their way down the pipeline through implementation (Carroll & Rounsaville, 2003, 2007; Craske, Roy-Byrne, et al., 2009).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Carroll & Rounsaville, 2003, 2007
- Not checked yetcites Craske, Roy-Byrne, et al., 2009
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Whether done by clinicians attempting to meet real-world demands or by scientists lacking evidence of the intervention’s mechanism of action, practical alteration of evidenced-based interventions could very well diminish or eliminate the potency of the (no-longer-science-based) interventions.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the Interventions: Adapting Square Pegs to Fit Into Round Holes
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“If we understood how and why an intervention is working, we are better positioned to emphasize what is potent.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: unclear — It is unclear whether it could be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Generally, when Stage II (rather than Stage III) is proposed, it is because the intervention is not ready to be tested in the community”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage III
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Skipping Stage III and proceeding from Stage II to Stage IV is not a typical path within the stage model.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage IV
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The infrastructure of existing delivery systems may be too weak to provide the complex, albeit high-quality empirically supported therapies practiced in efficacy studies (McLellan & Meyers, 2004).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the System
What the sources say
- Not checked yetcites McLellan & Meyers, 2004
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Changes to interventions are made with good intentions, often due to necessity (e.g., insurers’ demands), and they are frequently based on clinical intuition, clinical experience, or clinician or patient preferences, but not on science (Lilienfeld et al., 2013).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the Interventions: Adapting Square Pegs to Fit Into Round Holes
What the sources say
- Not checked yetcites Lilienfeld et al., 2013
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Despite substantial advances in the understanding of neurobiological, behavioral, and psychological mechanisms of disorders, these understandings are not sufficiently linked to mechanisms of action in intervention development research (Kazdin, 2007; Murphy, Cooper, Hollon, & Fairburn, 2009).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Kazdin, 2007
- Not checked yetcites Murphy, Cooper, Hollon, & Fairburn, 2009
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Knowing principles could also help clarify when it is important to intervene in one particular way, or to intervene in any number of ways, as long as the intervention is faithful to the mechanism of action.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: unclear — It is unclear whether it could be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“This may reflect the insufficiency of commonly used training and dissemination methods such as workshops and lectures, which by themselves effect little substantive change in clinician behavior (Miller, Yahne, Moyers, Martinez, & Pirritano, 2004; Sholomskas et al., 2005).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Miller, Yahne, Moyers, Martinez, & Pirritano, 2004
- Not checked yetcites Sholomskas et al., 2005
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“For instance, in one study CBT concepts were mentioned in fewer than 5% of sessions based on direct observation (Santa Ana, Martino, Ball, Nich, & Carroll, 2008).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Santa Ana, Martino, Ball, Nich, & Carroll, 2008
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Suggestions to solve the science-practice gap by changing the service delivery system have encountered formidable barriers.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the System
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“On the other side of the translation-implementation continuum (Shoham et al., 2014), we are missing a tighter link between basic and applied clinical science (Onken & Blaine, 1997; Onken & Bootzin, 1998).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Onken & Blaine, 1997
- Not checked yetcites Onken & Bootzin, 1998
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Despite this gap, many investigators still move directly from traditional efficacy studies (with research therapists) to effectiveness studies, without first conducting an efficacy (i.e., controlled) study with community therapists to ensure that the intervention being studied is implementable with fidelity when administered by community practitioners.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Decades of research with little attention to change mechanisms have produced very few interventions that are efficacious, effective, and implementable.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of course, prior to this testing the intervention will likely need to be further developed or adapted (i.e., in Stage I) for community providers.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage III
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Complex treatments delivered with high fidelity in research settings by research therapists tend to lose strength when delivered in community settings by community providers.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moving to an effectiveness study from Stage II, without validated measures to train community providers and ensure fidelity, increases the likelihood of a failed effectiveness trial.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage IV
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Complex treatments delivered with high fidelity in research settings by research therapists tend to lose strength when delivered in community settings by community providers.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Furthermore, even documented acquisition of fidelity skills under close supervision does not guarantee continued, postsupervision fidelity maintenance.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Any one of these systemic barriers could be difficult to change, and a synthesis of the literature suggests that successful implementation necessitates a sustained, multilevel approach (Damschroder et al., 2009; Fairburn & Wilson, 2013; Fixsen et al., 2005), requiring that multiple barriers be addressed simultaneously for implementation to be successful.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the System
What the sources say
- Not checked yetcites Damschroder et al., 2009
- Not checked yetcites Fairburn & Wilson, 2013
- Not checked yetcites Fixsen et al., 2005
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“For example, with an understanding of mechanisms, Otto et al. (2012) were able to create an ultra-brief treatment for panic disorder.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the Interventions: Adapting Square Pegs to Fit Into Round Holes
What the sources say
- Not checked yetcites Otto et al. (2012)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Basic science can also be incorporated into all other stages of intervention development.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage 0
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Basic science plays a major role in intervention development.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Efficacy and effectiveness research divorced from the science of how and why interventions work can yield interventions that work, and in some cases that can be good enough.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Concluding Remarks
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Stage III is meant to maximize the chances of a successful Stage IV study.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage IV
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 24
- Probably not a substantial claim. 36
In the paper
“Although efficacious behavioral treatments for many mental disorders exist, patients who seek treatment in community settings rarely receive them (Institute of Medicine, 2006).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Institute of Medicine, 2006
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Despite these frequent calls for studying change mechanisms in intervention development research, many clinical scientists are not yet taking this approach.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Research therapists tend to be committed to the therapy they are administering and to the research process, and they are directly incentivized to implement treatments with skill and fidelity.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
It may state two separate claims as one.
In the paper
“For example, in a study of clinical psychologists’ use of exposure therapy for posttraumatic stress disorder, only 17% of therapists reported using the evidence-based treatment, and 72% reported a lack of comfort with exposure therapy (Becker, Zayfert, & Anderson, 2004).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Becker, Zayfert, & Anderson, 2004
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As it turns out, nobody takes charge, and the cycle continues.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Another particularly unfortunate barrier is that empirically supported therapies are not always preferentially reimbursed, whereas some interventions that have been shown to be ineffective or worse (e.g., repeated inpatient detoxification without aftercare) continue to be reimbursed (Humphreys & McLellan, 2012).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the System
What the sources say
- Not checked yetcites Humphreys & McLellan, 2012
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We suggest that the development of potent and implementable behavioral interventions could be revolutionized if the field were unified around fundamental mechanisms of behavior change and if all types of clinical scientists were trained to address mechanism of action of behavioral interventions at every stage of the intervention development process.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
In the paper
“For example, implementation of such treatments may require fundamental changes in the training and ongoing supervision of community-based clinicians (Carroll & Rounsaville, 2007), smaller numbers of patients assigned to each clinician, and increased time allotted per patient.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the System
What the sources say
- Not checked yetcites Carroll & Rounsaville, 2007
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On the other hand, when clinical scientists uncover essential mechanisms of action, they may be able to package the intervention in a way that is highly implementable.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the Interventions: Adapting Square Pegs to Fit Into Round Holes
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Direct supervision, via review of clinicians’ levels of fidelity and skill in delivering evidence-based practice, is rarely provided in community-based settings and is also not reimbursed or otherwise incentivized (Olmstead et al., 2012; Schoenwald, Mehta, Frazier, & Shernoff, 2013).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
What the sources say
- Not checked yetcites Olmstead et al., 2012
- Not checked yetcites Schoenwald, Mehta, Frazier, & Shernoff, 2013
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Such alterations typically involve delivering the intervention in far fewer sessions, in group versus individual format, and other shortcuts that could diminish potency.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the Interventions: Adapting Square Pegs to Fit Into Round Holes
What the sources say
- Not checked yetcites Stewart, Stirman, & Chambless, 2012
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the need for students to acquire a more integrative vision of the entire field, to see themselves as part of it, and to understand how to interact with scientists in other parts of the clinical science system is critical for clinical science to flourish in the long term, and to achieve its rich potential for exerting a positive impact on public health.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What About Training of Clinical Scientists?
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
- Rests on an assumption: Most clinical researchers were not trained in an integrative outlook and are too embedded in current clinical research pressures to change quickly.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There is a clear disconnect between efficacy research that values internal validity and effectiveness research that prioritizes external validity at the expense of internal validity.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“a need has been identified for research between traditional efficacy and effectiveness research (Carroll & Rounsaville, 2007; Weisz et al., 2013).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage III
What the sources say
- Not checked yetcites Carroll & Rounsaville, 2007
- Not checked yetcites Weisz et al., 2013
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Researchers from the most basic realm of clinical science to the most applied realm of intervention development not only can help each other, but also can help themselves by opening up new avenues of research pursuits, and asking and answering new research questions—all while fostering the public health.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What About Training of Clinical Scientists?
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A successful Stage III trial shows that it is possible to deliver faithfully an intervention in the community, and that the intervention retains efficacy.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage IV
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Understanding mechanism could help to clarify scientifically based principles of interventions, and imparting these principles may help practitioners deliver interventions with a higher level of fidelity than requiring a strict adherence to intervention manuals.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“There have been numerous calls for research on mechanisms of change.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We suggest that a major reason for the relative lack of attention to mechanisms in prior research may be an unfortunate consequence of largely disconnected areas of clinical science.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Hence, basic science questions and relevant research paradigms should not be limited to research that occurs prior to intervention development; they are integral to the entire behavioral intervention development process.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although relevant to intervention development, not all D&I research looks at the intervention per se, except as something to be adopted by the system.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage V
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Indeed, one recent announcement, “Use-Oriented Basic Research: Change Mechanisms of Behavioral Social Interventions” (http://grants.nih.gov/grants/guide/pa-files/PA-12-119.html), called for research to study putative mechanisms of action of behavioral, with the ultimate goal of simplifying and creating more implementable interventions.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
What the sources say
- Not checked yetcites http://grants.nih.gov/grants/guide/pa-files/PA-12-119.html
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Generally speaking, dissemination and implementation (D&I) research focuses at least as much if not more on the service delivery system as opposed to the intervention itself.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage V
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Unfortunately, clinical scientists are not usually the conveyers of such modifications, nor do they always have the tools necessary to retain effective intervention ingredients while guiding adaptation efforts.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Changing the Interventions: Adapting Square Pegs to Fit Into Round Holes
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Simplification of interventions could help with training, cost, and transportability.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A meta-level problem is that these problems fall between scientific cracks.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What Are the Problems and Who Should Fix Them?
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Questions regarding mechanisms of disorders and mechanisms of change are conceptually similar to questions asked within basic behavioral science.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Possible Solutions > Identifying Mechanisms of Change
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This does not imply, however, that interventions at this stage are exempt from the desiderata regarding mechanism that are discussed in previous sections: It is important to understand how implementation strategies work.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage V
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A common language fosters a progressive discipline, creating the groundwork to solve public health problems.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Concluding Remarks
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This common language facilitates research grant proposal writing and review, ultimately leading to a more coherent, efficient, and progressive science.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Training students to use the stage model as a heuristic can help to foster all of these goals.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > What About Training of Clinical Scientists?
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The vision presented here demands that clinical scientists understand and train their students to understand that intervention development is far from complete when an intervention shows efficacy in Stage II.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Concluding Remarks
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
- Rests on an assumption: Complex treatments delivered with high fidelity in research settings by research therapists tend to lose strength when delivered in community settings by community providers.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A new vision for clinical science is, in a sense, equivalent to a new vision for intervention development, in that the ultimate goal of both is interventions that promote the physical and mental health of individuals.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Concluding Remarks
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, defining a stage in between efficacy and effectiveness, where interventions can be tested with high internal validity, with research therapists in research settings, draws attention to the importance of this stage of intervention development, and also provides more clarity when the words efficacy and effectiveness are used.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“For example, defining treatment generation and refinement helped to legitimize this necessary part of behavioral treatment research.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although the ultimate goal may be applied, basic science is an integral part of that goal because basic and all types of applied clinical scientists are necessary to fully achieve it.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Concluding Remarks
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Stage 0 can precede and provide the basis for the generation of a new intervention, or the modification of an existing one.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage 0
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds.
- Rests on an assumption: Basic science plays a major role in intervention development.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“With a common language, the (oftentimes) missing link of Stage III defined, and a mind-set that includes an appreciation of basic science and implementability within intervention development, we expect to replace the merry-go-round of efficacy and effectiveness trials that go nowhere with a map that leads toward implementation of effective interventions.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Concluding Remarks
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Basic science divorced from applied science can yield fascinating findings, but if basic science can inform and be informed by applied clinical science, the field can expand and can help solve public health problems, and be noticed for doing so.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Concluding Remarks
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Training the next generation of clinical scientists to embrace this new vision could mean a new generation of powerful and implementable interventions for the public health.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Concluding Remarks
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“It may be more complex to incorporate Stage 0 (basic science) into Stage IV than into Stages I to III, but there may be methods for doing so (Collins, Dziak, & Li, 2009; Doss & Atkins, 2006).”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage IV
What the sources say
- Not checked yetcites Collins, Dziak, & Li, 2009
- Not checked yetcites Doss & Atkins, 2006
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As discussed earlier, we believe that understanding the basic principles of behavior change for an intervention will fuel every stage of intervention development and will facilitate the creation of ever more potent and implementable interventions.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage 0
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.
- Rests on an assumption: Basic science plays a major role in intervention development.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Questions will still arise if the field is integrated, but the science will be better positioned to coherently progress.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Concluding Remarks
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Indeed, a Stage II study can provide an ideal opportunity to experimentally manipulate and test mechanisms.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage II
plain- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, defining the stages creates a common language through which behavioral intervention development can be discussed across clinical, academic, and research settings.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“On the other hand, without an understanding of mechanisms, endless questions can arise when clinical trials fail (e.g., questions about appropriateness of design, delivery, fidelity, population, providers, etc.) and even when they succeed”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Concluding Remarks
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“defining stages of behavioral intervention development highlights the value and frequent necessity of a particular type of research endeavor.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“If an intervention is not implementable in the community, there is more work to be done—even if that work ends up showing that there is no conceivable way currently to change the intervention into a more implementable form.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > Concluding Remarks
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.
- Rests on an assumption: Complex treatments delivered with high fidelity in research settings by research therapists tend to lose strength when delivered in community settings by community providers.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“So even though the stages of behavioral intervention development do not always—or even usually—occur in a prescribed order, and even though it is not always—or even usually—necessary to progress through every stage, it facilitates communication and helps clarify research activities and necessary next steps when the stages of intervention development research are defined.”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.
The paper relies on this without support.
Complex treatments delivered with high fidelity in research settings by research therapists tend to lose strength when delivered in community settings by community providers.
“Complex treatments administered with a high degree of fidelity in research settings with research therapists seem destined to weaken when implemented in community settings with community providers.”
The paper relies on this without support.
Most clinical researchers were not trained in an integrative outlook and are too embedded in current clinical research pressures to change quickly.
“Realistically, the large majority of clinical researchers, sympathetic as they may be to this sort of integrative vision, were not trained in this kind of outlook and are far too ensconced in the intense pressure of contemporary clinical research to change rapidly.”
The paper relies on this without support.
Clinical science training currently produces excellent basic scientists, intervention developers and testers, effectiveness researchers, and implementation scientists.
“Moreover, clinical science training now produces excellent basic scientists, intervention generators and testers, effectiveness researchers, and implementation scientists.”
The paper relies on this without support.
It is generally considered necessary to demonstrate that an intervention is effective before moving to implementation and dissemination in real-world settings.
“It is generally considered necessary to show that an intervention is effective before proceeding to implementation and dissemination in the real world.”
The paper relies on this without support.
Basic science plays a major role in intervention development.
“Basic science, considered to be Stage 0, plays a major role in intervention development.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“It is recommended to conduct a pilot trial before the real RCT to assess feasibility and improve the quality of the real RCT [20–22].”
From A pilot randomised trial comparing a mindfulness-based stress reduction course, a locally-developed stress reduction intervention and a waiting list control group in a real-life municipal health care setting (2020) · cites this paper as [21]
Experimental — accuracy not yet measuredIn the citing paper
“Conversely, community healthcare providers face real-world practical constraints and limited resources, which means they adapt treatment manuals to their service needs or broaden the population to which the intervention is applied (Onken et al. 2014).”
From The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services (2020) · cites this paper as Onken et al. 2014
In the citing paper
“As a program of research matures (e.g., moves through the stages of intervention development)11,39,40, increasingly rigorous and theoretically therapeutic control conditions may be warranted, both for ethical (e.g., beneficence and non-maleficence)53 and scientific reasons (i.e., determining how a novel treatment compares with established treatments).”
From Selecting and describing control conditions in mobile health randomized controlled trials: a proposed typology (2023) · cites this paper as [39]
In the citing paper
“There is no single control condition that is appropriate for every study at every stage of the research process11,12,39.”
From Selecting and describing control conditions in mobile health randomized controlled trials: a proposed typology (2023) · cites this paper as [39]
In the citing paper
“In early stages of research39,40, No Treatment controls may be very appropriate in order to evaluate intervention effects beyond the passage of time and related confounds (e.g., regression to the mean)41.”
From Selecting and describing control conditions in mobile health randomized controlled trials: a proposed typology (2023) · cites this paper as [39]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model
“defining a stage in between efficacy and effectiveness, where interventions can be tested with high internal validity, with research therapists in research settings”
§ Reenvisioning Clinical Science: Unifying the Discipline to Improve the Public Health > NIH Stage Model > Stage III
“This new vision of intervention development includes an additional stage, Stage III, of research where an intervention is tested in a well-controlled, internally valid study in a community setting with community therapists/providers”
Citations
Cites
Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009) · Implementation Science · doi:10.1186/1748-5908-4-50 · Cited by 14,496 · cited 2×
“Any one of these systemic barriers could be difficult to change, and a synthesis of the literature suggests that successful implementation necessitates a sustained, multilevel approach (Damschroder et al., 2009; Fairburn & Wilson, 2013; Fixsen et al., 2005), requiring that multiple barriers be addressed simultaneously…”
(2005) · Cited by 3,748
Toward the future of psychiatric diagnosis: the seven pillars of RDoC
Cuthbert, B. N., & Insel, T. R. (2013) · BMC Medicine · doi:10.1186/1741-7015-11-126 · Cited by 3,053 · cited 1×
“…exhibit considerable heterogeneity (British Psychological Society, 2011; Frances, 2009a, 2009b), our understanding of the basic processes of psychopathology that should be addressed in targeted treatments has substantially increased (T. A. Brown & Barlow, 2009; Cuthbert & Insel, 2013; Insel, 2012).”
Self-citationMediators and Mechanisms of Change in Psychotherapy Research
Kazdin, A. E. (2007) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.3.022806.091432 · Cited by 2,504 · cited 2×
“Despite substantial advances in the understanding of neurobiological, behavioral, and psychological mechanisms of disorders, these understandings are not sufficiently linked to mechanisms of action in intervention development research (Kazdin, 2007; Murphy, Cooper, Hollon, & Fairburn, 2009).”
Empirically supported psychological interventions: Controversies and evidence
Chambless, D. L., & Ollendick, T. H. (2001) · Annual Review of Psychology · doi:10.1146/annurev.psych.52.1.685 · Cited by 2,097
Pasteur's Quadrant: Basic Science and Technological Innovation
Tierney, W. G., Stokes, D., & Abbott, A. J. (2005) · Academe · doi:10.2307/40253438 · Cited by 2,078
Proctor, E. K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., & Mittman, B. (2009) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-008-0197-4 · Cited by 1,894 · cited 1×
“Finally, consider the implementation scientists (e.g., Proctor et al., 2009).”
Glasgow, R. E., Lichtenstein, E., & Marcus, A. C. (2003) · American Journal of Public Health · doi:10.2105/ajph.93.8.1261 · Cited by 1,836
The effects of psychotherapy: an evaluation.
Eysenck, H. J. (1952) · Journal of Consulting Psychology · doi:10.1037/h0063633 · Cited by 1,734
Kazdin, A. E. (2008) · American Psychologist · doi:10.1037/0003-066x.63.3.146 · Cited by 1,112 · cited 1×
“As Kazdin (2008) pointed out, “There are many reasons to study mechanisms, but one in particular will help clinical work and patient care” (p. 152).”
Research works printed but not linked: 3
- Institute of Medicine, 2006, Improving the quality of health care for mental and substance-use conditions: Quality chasm series
- Kringlen E., 1970, Seminars in Psychiatry, 2, 403
- McFall R. M., 2007, Psychological clinical science: Recent advances in theory and practice. Integrative perspectives in honor of Richard M. McFall, 363
Cited by
Sorted by citations
Van Dam, N. T., van Vugt, M. K., Vago, D. R., Schmalzl, L., Saron, C. D., Olendzki, A., Meissner, T., Lazar, S. W., Kerr, C. E., Gorchov, J., et al. (2018) · Perspectives on Psychological Science · doi:10.1177/1745691617709589 · Cited by 1,506
“Dimidjian and Segal (2015) estimate, using the NIH stage model for clinical science (Onken, Carroll, Shoham, Cuthbert, & Riddle, 2014), that only 30% of research using mind-fulness-based interventions (MBIs) has moved beyond Stage 1 (intervention generation/refinement).”
What defines mindfulness-based programs? The warp and the weft
Crane, R. S., Brewer, J., Feldman, C., Kabat-Zinn, J., Santorelli, S., Williams, J. M. G., & Kuyken, W. (2017) · Psychological Medicine · doi:10.1017/s0033291716003317 · Cited by 868
“In this editorial we focus on a critical underpinning issue throughout the Stage Model – namely the fi delity/integrity of the intervention itself.”
Carey, R., Bohlen, L. C., Johnston, M., Rothman, A. J., de Bruin, M., Kelly, M. P., & Michie, S. (2018) · Annals of Behavioral Medicine · doi:10.1093/abm/kay078 · Cited by 743
“…their effects, through identification of the links between behavior change techniques (BCTs) and the MoAs they target, Susan Michie s.michie@ucl.ac.uk would enable us to (i) design interventions that include components more likely to be effective [6] and (ii) better explain intervention effects.”
BackgroundNielsen, L., Riddle, M., King, J. W., Aklin, W. M., Chen, W., Clark, D., Collier, E., Czajkowski, S., Esposito, L., Ferrer, R., et al. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.07.002 · Cited by 446
Self-citationMediation, Moderation, and Conditional Process Analysis
Rockwood, N., & Hayes, A. F. (2020) · Cambridge University Press eBooks · doi:10.1017/9781316995808.037 · Cited by 479
Metadata
- Authors
- Onken, L. S., Carroll, K. M., Shoham, V., Cuthbert, B. N., & Riddle, M.
- Affiliations
- National Institute on Drug Abuse (US)
- Yale University (US)
- National Institute of Mental Health (US)
- National Institute of Dental and Craniofacial Research (US)
- Corresponding author
- Onken, Lisa S.
- Venue
- Clinical Psychological Science
- Publisher
- SAGE Publications
- Published
- 2013-12-11
- Volume
- 2
- Issue
- 1
- Pages
- 22-34
- ISSN
- 2167-7026 (ISSN-L)
- 2167-7034
- PMC
- PMC4374633
- OpenAlex
- W2013335489
- Cited by
- 872
- References
- 87
- Citations by year
- 2026: 93 · 2025: 123 · 2024: 107 · 2023: 117 · 2022: 90 · 2021: 101 · 2020: 70 · 2019: 58 · 2018: 35 · 2017: 40 · 2016: 18 · 2015: 12 · 2014: 6 · 2013: 2
- FWCI
- 22.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Psychological Science (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99 DA999999)
- National Institute on Drug Abuse (P50DA009241, U10DA015831, R01DA015969)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health and Medical Research Impacts
- Social Sciences › Arts and Humanities › History and Philosophy of Science › Interdisciplinary Research and Collaboration
- Keywords
- clinical science, intervention development, stage model, intervention mechanisms, translational research, research training, implementation, prevention interventions, therapeutic interventions
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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