A rational model for assessing and evaluating complex interventions in health care
Open accessAbstract
BACKGROUND: Understanding how new clinical techniques, technologies and other complex interventions become normalized in practice is important to researchers, clinicians, health service managers and policy-makers. This paper presents a model of the normalization of complex interventions. METHODS: Between 1995 and 2005 multiple qualitative studies were undertaken. These examined: professional-patient relationships; changing patterns of care; the development, evaluation and implementation of telemedicine and related informatics systems; and the production and utilization of evidence for practice. Data from these studies were subjected to (i) formative re-analysis, leading to sets of analytic propositions; and to (ii) a summative analysis that aimed to build a robust conceptual model of the normalization of complex interventions in health care. RESULTS: A normalization process model that enables analysis of the conditions necessary to support the introduction of complex interventions is presented. The model is defined by four constructs: interactional workability; relational integration; skill set workability and contextual integration. This model can be used to understand the normalization potential of new techniques and technologies in healthcare settings CONCLUSION: The normalization process model has face validity in (i) assessing the potential for complex interventions to become routinely embedded in everyday clinical work, and (ii) evaluating the factors that promote or inhibit their success and failure in practice.
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A selection of approaches looked at whether the initiative benefits were perceived by staff and other stakeholders as valuable.
“A selection of approaches took a wider perspective and looked at whether the initiative benefits were perceived by staff and other stakeholders as valuable [8, 30, 42, 51, 61-63].”
From Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare (2018) · cites this paper as [51]
As an applied theoretical model, the NPM was restricted to a specific field of activity: the operationalization of complex healthcare interventions.
“As an applied theoretical model, the NPM was restricted to a specific field of activity: the operationalization of complex healthcare interventions [7].”
From Development of a theory of implementation and integration: Normalization Process Theory (2009) · cites this paper as [7]
By the end of 2006, the NPM in its published form was sufficient as a set of conceptual tools to analyse specific processes, and it has been successfully applied to this purpose.
“By the end of 2006, the NPM in its published form [7] was sufficient as a set of conceptual tools to analyse specific processes, and it has been successfully applied to this purpose [32-36].”
From Development of a theory of implementation and integration: Normalization Process Theory (2009) · cites this paper as [7]
A complex intervention is disposed to normalization if it confers an interactional advantage in flexibly accomplishing congruence and disposal.
“1. A complex intervention is disposed to normalization if it confers an interactional advantage in flexibly accomplishing congruence and disposal;”
From Development of a theory of implementation and integration: Normalization Process Theory (2009) · cites this paper as [7]
A complex intervention is disposed to normalization if it confers an advantage on an organization in flexibly executing and realizing work.
“4. A complex intervention is disposed to normalization if it confers an advantage on an organization in flexibly executing and realizing work.”
From Development of a theory of implementation and integration: Normalization Process Theory (2009) · cites this paper as [7]
A complex intervention is disposed to normalization if it equals or improves accountability and confidence within networks.
“2. A complex intervention is disposed to normalization if it equals or improves accountability and confidence within networks;”
From Development of a theory of implementation and integration: Normalization Process Theory (2009) · cites this paper as [7]
The development of explanatory ideas around normalization has shifted from an initial set of empirical generalizations presented as synthetic propositions or assertions [17], to a robust conceptual model that presented generalizable propositions [7], and finally to a middle-range theory that offers a set of mechanism-based explanations for processes of implementation, embedding, and integration [5
“The development of a set of explanatory ideas around normalization has shifted from an initial set of empirical generalizations presented as synthetic propositions or assertions [17], to a robust conceptual model that presented generalizable propositions [7], and finally to a middle-range theory that offers a set of mechanism-based explanations for processes of implementation, embedding, and integ”
From Development of a theory of implementation and integration: Normalization Process Theory (2009) · cites this paper as [7]
A complex intervention is disposed to normalization if it is calibrated to an agreed skill-set at a recognizable location in the division of labour.
“3. A complex intervention is disposed to normalization if it is calibrated to an agreed skill-set at a recognizable location in the division of labour;”
From Development of a theory of implementation and integration: Normalization Process Theory (2009) · cites this paper as [7]
Normalisation process theory lacks a theoretical perspective on the technology itself and remains explicitly couched in assumptions of 'rationality' rather than in normative concerns about what constitutes good clinical practice.
“The theory recognises the complex nature of healthcare work and the human relationships on which that work depends, but it lacks a theoretical perspective on the technology itself and remains explicitly couched in assumptions of 'rationality' rather than in normative concerns about what constitutes good clinical practice.52”
The precursor to NPT, the normalization process model (NPM), originated from a large body of work on eHealth and was developed to explain the observation that many eHealth initiatives failed to embed into routine practice.
“The precursor to NPT, normalization process model (NPM), originated from a large body of work on eHealth and was developed to explain the observation that many eHealth initiatives failed to embed into routine practice [112,113].”
From Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress (2012) · cites this paper as [113]
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Self-citationDevelopment of a theory of implementation and integration: Normalization Process Theory
May, C. R., Mair, F., Finch, T., MacFarlane, A., Dowrick, C., Treweek, S., Rapley, T., Ballini, L., Ong, B. N., Rogers, A., et al. (2009) · Implementation Science · doi:10.1186/1748-5908-4-29 · Cited by 1,409 · see citing works
“However, after a formal Normalization Process Model [7] was developed and presented at seminars and conferences during 2005 and 2006, a multi-disciplinary group of researchers formed around the model and began to refine and develop it – and, most importantly, to apply it to specific research problems.”
InfluentialSelf-citationImplementation, context and complexity
May, C. R., Johnson, M., & Finch, T. (2016) · Implementation Science · doi:10.1186/s13012-016-0506-3 · Cited by 978 · see citing works
Self-citationMay, C. R., Cummings, A., Girling, M., Bracher, M., Mair, F. S., May, C. M., Murray, E., Myall, M., Rapley, T., & Finch, T. (2018) · Implementation Science · doi:10.1186/s13012-018-0758-1 · Cited by 683 · see citing works
“4 Interactions between NPM mechanisms: relational integration as an obligatory point of passage (Holtrop et al. [99]) processes.”
BackgroundSelf-citationMay, C., Finch, T., Mair, F., Ballini, L., Dowrick, C., Eccles, M., Gask, L., MacFarlane, A., Murray, E., Rapley, T., et al. (2007) · BMC Health Services Research · doi:10.1186/1472-6963-7-148 · Cited by 768 · see citing works
Self-citationShippee, N. D., Shah, N. D., May, C. R., Mair, F. S., & Montori, V. M. (2012) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2012.05.005 · Cited by 728 · see citing works
Self-citationCresswell, K., & Sheikh, A. (2013) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2012.10.007 · Cited by 690 · see citing works
Towards a general theory of implementation
May, C. (2013) · Implementation Science · doi:10.1186/1748-5908-8-18 · Cited by 656 · see citing works
Self-citationLessons from Complex Interventions to Improve Health
Hawe, P. (2015) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031912-114421 · Cited by 607 · see citing works
Making trials matter: pragmatic and explanatory trials and the problem of applicability
Treweek, S. P., & Zwarenstein, M. (2009) · Trials · doi:10.1186/1745-6215-10-37 · Cited by 482 · see citing works
McEvoy, R., Ballini, L., Maltoni, S., O’Donnell, C. A., Mair, F. S., & MacFarlane, A. (2014) · Implementation Science · doi:10.1186/1748-5908-9-2 · Cited by 413 · see citing works
Clinician Acceptance is the Key Factor for Sustainable Telehealth Services
Wade, V. A., Eliott, J. A., & Hiller, J. E. (2014) · Qualitative Health Research · doi:10.1177/1049732314528809 · Cited by 410 · see citing works
Lennox, L., Maher, L., & Reed, J. (2018) · Implementation Science · doi:10.1186/s13012-017-0707-4 · Cited by 421 · see citing works
Normalising the “new normal”: Changing tech-driven work practices under pandemic time pressure
Carroll, N., & Conboy, K. (2020) · International Journal of Information Management · doi:10.1016/j.ijinfomgt.2020.102186 · Cited by 360 · see citing works
Standards for Reporting Implementation Studies (StaRI): explanation and elaboration document
Pinnock, H., Barwick, M. A., Carpenter, C. R., Eldridge, S. M., Grandes, G., Griffiths, C., Rycroft‐Malone, J., Meißner, P., Murray, E., Patel, A. K., et al. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-013318 · Cited by 342 · see citing works
Support for self care for patients with chronic disease
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Why is it difficult to implement e-health initiatives? A qualitative study
Murray, E., Burns, J., May, C., Finch, T., O'Donnell, C., Wallace, P., & Mair, F. (2011) · Implementation Science · doi:10.1186/1748-5908-6-6 · Cited by 270 · see citing works
Self-citationSligo, J. L., Gauld, R. D. C., Roberts, V., & Villa, L. (2016) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2016.09.007 · Cited by 277 · see citing works
May, C. R., Albers, B., Bracher, M., Finch, T. L., Gilbert, A. W., Girling, M., Greenwood, K., MacFarlane, A. E., Mair, F. S., May, C., et al. (2022) · Implementation Science · doi:10.1186/s13012-022-01191-x · Cited by 241 · see citing works
Self-citationMay, C. R., Finch, T. L., Ballini, L., MacFarlane, A. E., Mair, F. S., Murray, E., Treweek, S., & Rapley, T. (2011) · Arrow@dit (Dublin Institute of Technology) · doi:10.34961/10032 · Cited by 235 · see citing works
Self-citationUsing a Theory-Driven Conceptual Framework in Qualitative Health Research
MacFarlane, A. E., & Brún, M. O.-D. (2011) · Qualitative Health Research · doi:10.1177/1049732311431898 · Cited by 229 · see citing works
Integrating telecare for chronic disease management in the community: What needs to be done?
May, C. R., Finch, T. L., Cornford, J., Exley, C., Gately, C., Kirk, S., Jenkings, K. N., Osbourne, J., Robinson, A. L., Rogers, A., et al. (2011) · BMC Health Services Research · doi:10.1186/1472-6963-11-131 · Cited by 220 · see citing works
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Web-Based Interventions for Behavior Change and Self-Management: Potential, Pitfalls, and Progress
Murray, E. (2012) · Medicine 2.0 · doi:10.2196/med20.1741 · Cited by 219 · see citing works
Agency and implementation: Understanding the embedding of healthcare innovations in practice
May, C. (2013) · Social Science & Medicine · doi:10.1016/j.socscimed.2012.11.021 · Cited by 189 · see citing works
Self-citationMay, C. R., Mair, F. S., Dowrick, C. F., & Finch, T. L. (2007) · BMC Family Practice · doi:10.1186/1471-2296-8-42 · Cited by 183 · see citing works
Self-citationFinch, T. L., Rapley, T., Girling, M., Mair, F. S., Murray, E., Treweek, S., McColl, E., Steen, I. N., & May, C. R. (2013) · Implementation Science · doi:10.1186/1748-5908-8-43 · Cited by 177 · see citing works
Self-citationBand, R. J., Bradbury, K. J., Morton, K., May, C. R., Michie, S., Mair, F. S., Murray, E., McManus, R. J., Little, P. S., & Yardley, L. (2017) · Implementation Science · doi:10.1186/s13012-017-0553-4 · Cited by 166 · see citing works
Self-citationElwyn, G., Légaré, F., Weijden, T. V. D., Edwards, A., & May, C. (2008) · Implementation Science · doi:10.1186/1748-5908-3-57 · Cited by 159 · see citing works
Self-citationvan Staa, T. P., Dyson, L., McCann, G., Padmanabhan, S., Belatri, R., Goldacre, B. M., Cassell, J., Pirmohamed, M., Torgerson, D. J., Ronaldson, S. J., et al. (2014) · Health Technology Assessment · doi:10.3310/hta18430 · Cited by 154 · see citing works
Improving recruitment to health research in primary care
Bower, P., Wallace, P., Ward, E. S., Graffy, J., Miller, J. M., Delaney, B. C., & Kinmonth, A. L. (2009) · Family Practice · doi:10.1093/fampra/cmp037 · Cited by 155 · see citing works
Overbeck, G., Davidsen, A. S., & Kousgaard, M. B. (2016) · Implementation Science · doi:10.1186/s13012-016-0519-y · Cited by 154 · see citing works
Huddlestone, L., Turner, J., Eborall, H., Hudson, N., Davies, M. J., & Martin, G. P. (2020) · BMC Family Practice · doi:10.1186/s12875-020-01107-y · Cited by 154 · see citing works
Desperately Seeking Dissonance
Booth, A., Carroll, C., Ilott, I., Low, L. L., & Cooper, K. L. (2012) · Qualitative Health Research · doi:10.1177/1049732312466295 · Cited by 142 · see citing works
Ross, J., Stevenson, F. A., Dack, C., Pal, K., May, C. R., Michie, S., Barnard, M., & Murray, E. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3615-7 · Cited by 142 · see citing works
Self-citationFinch, T. L., Mair, F. S., O’Donnell, C., Murray, E., & May, C. R. (2012) · BMC Medical Research Methodology · doi:10.1186/1471-2288-12-69 · Cited by 127 · see citing works
Self-citationDeneckere, S., Euwema, M., Lodewijckx, C., Panella, M., Mutsvari, T., Sermeus, W., & Vanhaecht, K. (2012) · Medical Care · doi:10.1097/mlr.0b013e3182763312 · Cited by 135 · see citing works
Boehmer, K. R., Dabrh, A. M. A., Gionfriddo, M. R., Erwin, P. J., & Montori, V. M. (2018) · PLoS ONE · doi:10.1371/journal.pone.0190852 · Cited by 138 · see citing works
Adopting and assimilating new non-pharmaceutical technologies into health care: A systematic review
Robert, G., Greenhalgh, T., Macfarlane, F., & Peacock, R. (2010) · Journal of Health Services Research & Policy · doi:10.1258/jhsrp.2010.009137 · Cited by 119 · see citing works
Characteristics of successfully implemented telemedical applications
Obstfelder, A. U., Engeseth, K. H., & Wynn, R. (2007) · Implementation Science · doi:10.1186/1748-5908-2-25 · Cited by 123 · see citing works
Bower, P., Cartwright, M., Hirani, S. P., Barlow, J. G., Hendy, J., Knapp, M. R. J., Henderson, C., Rogers, A. E., Sanders, C., Bardsley, M., et al. (2011) · BMC Health Services Research · doi:10.1186/1472-6963-11-184 · Cited by 119 · see citing works
Understanding factors that inhibit or promote the utilization of telecare in chronic lung disease
Mair, F. S., Hiscock, J., & Beaton, S. C. (2008) · Chronic Illness · doi:10.1177/1742395308092482 · Cited by 115 · see citing works
Experiences of abortion: A narrative review of qualitative studies
Lie, M., Robson, S. C., & May, C. R. (2008) · BMC Health Services Research · doi:10.1186/1472-6963-8-150 · Cited by 115 · see citing works
Self-citationHughes, A., Burridge, J. H., Demain, S. H., Ellis‐Hill, C., Meagher, C., Triccas, L. T., Turk, R., & Swain, I. (2014) · BMC Health Services Research · doi:10.1186/1472-6963-14-124 · Cited by 112 · see citing works
Rütten, A., Frahsa, A., Abel, T., Bergmann, M., de Leeuw, E., Hunter, D., Jansen, M., King, A., & Potvin, L. (2019) · Health Promotion International · doi:10.1093/heapro/dax053 · Cited by 109 · see citing works
Why do interventions work in some places and not others: A breastfeeding support group trial
Hoddinott, P., Britten, J., & Pill, R. (2009) · Social Science & Medicine · doi:10.1016/j.socscimed.2009.10.067 · Cited by 103 · see citing works
Development and formative evaluation of the e-Health Implementation Toolkit (e-HIT)
Murray, E., May, C., & Mair, F. (2010) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-10-61 · Cited by 96 · see citing works
Self-citationKirsh, S. R., Lawrence, R. H., & Aron, D. C. (2008) · Implementation Science · doi:10.1186/1748-5908-3-34 · Cited by 94 · see citing works
Bales, D. L., Timman, R., Luyten, P., Busschbach, J. J. V., Verheul, R., & Hutsebaut, J. (2017) · Personality and Mental Health · doi:10.1002/pmh.1381 · Cited by 93 · see citing works
May, C. R., Sibley, A., & Hunt, K. J. (2013) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2013.06.019 · Cited by 90 · see citing works
Self-citationDefining the external implementation context: an integrative systematic literature review
Watson, D. P., Adams, E. L., Shue, S. A., Coates, H., McGuire, A. B., Chesher, J., Jackson, J. R., & Omenka, O. I. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3046-5 · Cited by 96 · see citing works
Nurses’ use of computerised clinical decision support systems: a case site analysis
Dowding, D., Mitchell, N., Randell, R., Foster, R., Lattimer, V., & Thompson, C. A. (2009) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2008.02607.x · Cited by 92 · see citing works
Rowley, E., Morriss, R. K., Currie, G., & Schneider, J. M. (2012) · Implementation Science · doi:10.1186/1748-5908-7-40 · Cited by 92 · see citing works
Making change last? Exploring the value of sustainability approaches in healthcare: a scoping review
Lennox, L., Linwood-Amor, A., Maher, L., & Reed, J. E. (2020) · Health Research Policy and Systems · doi:10.1186/s12961-020-00601-0 · Cited by 94 · see citing works
New approaches to evaluating complex health and care systems
Lamont, T., Barber, N., de Pury, J., Fulop, N., Garfield-Birkbeck, S., Lilford, R. J., Mear, L., Raine, R., & Fitzpatrick, R. M. (2016) · BMJ · doi:10.1136/bmj.i154 · Cited by 87 · see citing works
Theoretical reflections on the nexus between research, policy and practice
de Leeuw, E., McNess, A., Crisp, B. R., & Stagnitti, K. E. (2008) · Critical Public Health · doi:10.1080/09581590801949924 · Cited by 84 · see citing works
Did a quality improvement collaborative make stroke care better? A cluster randomized trial
Power, M., Tyrrell, P. J., Rudd, A. G., Tully, M. P., Dalton, D., Marshall, M., Chappell, I., Corgie, D., Goldmann, D. A., Webb, D., et al. (2014) · Implementation Science · doi:10.1186/1748-5908-9-40 · Cited by 84 · see citing works
Understanding the implementation and integration of e-health services
Mair, F., May, C., Finch, T., Murray, E., Anderson, G. K., Sullivan, F., O'Donnell, C., Wallace, P., & Epstein, O. (2007) · Journal of Telemedicine and Telecare · doi:10.1258/135763307781645112 · Cited by 105 · see citing works
Self-citationBonten, T. N., Rauwerdink, A., Wyatt, J. C., Kasteleyn, M. J., Witkamp, L., Riper, H. M., van Gemert‐Pijnen, J. E. W. C., Cresswell, K. M., Sheikh, A., Schijven, M. P., et al. (2020) · Journal of Medical Internet Research · doi:10.2196/17774 · Cited by 81 · see citing works
Teledermatology for chronic disease management: coherence and normalization
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Godfrey, M., Smith, J., Green, J., Cheater, F., Inouye, S. K., & Young, J. B. (2013) · BMC Health Services Research · doi:10.1186/1472-6963-13-341 · Cited by 77 · see citing works
Saboury, B., Bradshaw, T., Boellaard, R., Buvat, I., Dutta, J., Hatt, M., Jha, A. K., Li, Q., Liu, C., McMeekin, H., et al. (2022) · Journal of Nuclear Medicine · doi:10.2967/jnumed.121.263703 · Cited by 77 · see citing works
Embedding effective depression care: using theory for primary care organisational and systems change
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Gask, L., Bower, P., Lovell, K., Escott, D., Archer, J., Gilbody, S., Lankshear, A. J., Simpson, A. E., & Richards, D. A. (2010) · Implementation Science · doi:10.1186/1748-5908-5-15 · Cited by 75 · see citing works
Coupe, N., Anderson, E. C., Gask, L. L., Sykes, P. A., Richards, D. A., & Chew-Graham, C. A. (2014) · BMC Family Practice · doi:10.1186/1471-2296-15-78 · Cited by 75 · see citing works
Exploring implementation and sustainability of models of care: can theory help?
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Innovation in mental health services: what are the key components of success?
Brooks, H. L., Pilgrim, D. M., & Rogers, A. E. (2011) · Implementation Science · doi:10.1186/1748-5908-6-120 · Cited by 72 · see citing works
Greenhalgh, T., Swinglehurst, D., & Stones, R. (2014) · Health Services and Delivery Research · doi:10.3310/hsdr02390 · Cited by 71 · see citing works
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Richards, D., Bower, P., Chew-Graham, C., Gask, L., Lovell, K., Cape, J., Pilling, S., Araya, R., Kessler, D., Barkham, M., et al. (2016) · Health Technology Assessment · doi:10.3310/hta20140 · Cited by 52 · see citing works
Studying Scale-Up and Spread as Social Practice: Theoretical Introduction and Empirical Case Study
Shaw, J., Shaw, S. E., Wherton, J. P., Hughes, G., & Greenhalgh, T. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7482 · Cited by 67 · see citing works
Implementation of sustainable complex interventions in health care services: the triple C model
Khalil, H., & Kynoch, K. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06115-x · Cited by 71 · see citing works
Kennedy, A., Chew-Graham, C., Blakeman, T., Bowen, A., Gardner, C., Protheroe, J., Rogers, A., & Gask, L. (2010) · Implementation Science · doi:10.1186/1748-5908-5-7 · Cited by 66 · see citing works
Bower, P., Kennedy, A. P., Reeves, D., Rogers, A. E., Blakeman, T., Chew-Graham, C. A., Bowen, R., Eden, M., Gardner, C., Hann, M., et al. (2012) · Implementation Science · doi:10.1186/1748-5908-7-7 · Cited by 65 · see citing works
Leon, N., Lewin, S. A., & Mathews, C. (2013) · Implementation Science · doi:10.1186/1748-5908-8-97 · Cited by 65 · see citing works
Nazar, H., Brice, S., Akhter, N., Kasim, A., Gunning, A., Slight, S. P., & Watson, N. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-012532 · Cited by 63 · see citing works
Coleman, T. J., Agboola, S., Leonardi‐Bee, J., Taylor, M. J., McEwen, A., & McNeill, A. D. (2010) · Health Technology Assessment · doi:10.3310/hta14490 · Cited by 61 · see citing works
The influence of context and process when implementing e-health
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Boonstra, A., Boddy, D., & Bell, S. (2008) · European Journal of Information Systems · doi:10.1057/ejis.2008.2 · Cited by 61 · see citing works
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Watson, D. P., Young, J., Ahonen, E. Q., Xu, H., Henderson, M. L., Shuman, V., & Tolliver, R. (2014) · Implementation Science · doi:10.1186/s13012-014-0138-4 · Cited by 58 · see citing works
Phulkerd, S., Sacks, G., Vandevijvere, S., Worsley, A. F., & Lawrence, M. A. (2017) · Food Policy · doi:10.1016/j.foodpol.2017.07.014 · Cited by 58 · see citing works
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Performing Economic Evaluation of Integrated Care: Highway to Hell or Stairway to Heaven?
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From transformation to normalisation: An exploratory study of a large-scale agile transformation
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Beyond the limits of clinical governance? The case of mental health in English primary care
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- Authors
- May, C.
- Affiliations
- Newcastle University (GB)
- Corresponding author
- May, Carl
- ORCID
- May, Carl
- Venue
- BMC Health Services Research
- Published
- 2006-12
- Volume
- 6
- Issue
- 1
- Pages
- 86-86
- ISSN
- 1472-6963 (ISSN-L)
- OpenAlex
- W1487109350
- Cited by
- 447
- References
- 90
- Citations by year
- 2026: 10 · 2025: 22 · 2024: 21 · 2023: 17 · 2022: 29 · 2021: 40 · 2020: 27 · 2019: 13 · 2018: 18 · 2017: 28 · 2016: 23 · 2015: 25 · 2014: 31 · 2013: 21 · 2012: 21
- FWCI
- 32.02
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- University of Toronto
- Economic and Social Research Council (RES-000-27-0084)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Social Sciences › Sociology and Political Science › Information Systems Theories and Implementation
- Keywords
- complex interventions, telemedicine, professional-patient relationship, evidence-based practice, relational integration, contextual integration
- MeSH terms
- Chronic Disease, Depression, Diffusion of Innovation, United Kingdom, Humans, Outcome and Process Assessment, Health Care, Sociology, Medical, Systems Analysis, Technology Assessment, Biomedical, Reproducibility of Results, Low Back Pain, Models, Organizational, Telemedicine, Evidence-Based Medicine, Qualitative Research
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.
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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