MRC Complex Intervetions Framework

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What are cross-sectional studies used for?
Determining if a mechanism is correlated with symptom severity.
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What are longitudinal studies used for?
Determining if a mechanism at time one predicts symptom severity at time two, even when controlling for severity at time one.
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What are manipulation designs used for?
Assessing if you experimentally increase/ decrease a mechanism, does this alter symptoms severity.
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What do mediation methods consist of?
Measuring the change in a mechanisms pre- to post- therapy and seeing if this predicts clinical outcomes, in order to establish if repairing it is the active ingredient of therapy.
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What do dismantling studies consist of?
Understanding the effects of individual components on other components and on the outcome.
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What is process-outcome research?
Measuring change on a week to week basis in therapy to try and understand how it works.
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What are the pros of process-outcome research (1)?
Tells you how a treatment is working over real time.
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What are the cons of process outcome research (3)?
Have to take repeated measures, involved laborious coding of therapy tapes to get at content, reliant on observation and self report.
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What is clinical audit?
A quality improvement process that seeks to improve patient care and outcomes through systematic review of explicit criteria and the implementation of change.
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What are the pros of clinical audit (3)?
Good for assessing adequacy of a treatment/ service, can improve clinical practice, includes service user perspective.
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What are the cons of clinical audit (5)?
Lack of resources to do rigorously, results can go nowhere, can't generalise beyond research situation, subject to bias, rarely published so have limited audiences.
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What are qualitative methods?
Use of opinions, experiences and feelings, producing subjective data focusing on situations as they naturally occur.
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What are the pros of qualitative research (6)?
Yields rich data, captures individual experience, explores topics in depth, can explain/ elaborate in interviews increasing validity, flexible to accommodate individual needs, gains service user perspective.
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What are the cons of qualitative research (8)?
Time consuming and expensive, need qualified interviewers, interviewee may distort information, flexibility can result in inconsistencies, volume of information can be too large, subjective, not necessarily replicable, not easily generalised.
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What are health economics used for?
Determining if clinical benefits a treatment delivers are 'value for money.'
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What can be calculated in health economics (3)?
Direct cost of administering treatment, indirect savings from administering treatment, health benefits/ effects in terms of improvement (QALYs or drop in symptoms).
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What is the incremental cost effective ratio (ICER)?
Difference in costs divided by difference in benefits.
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What is the process of the linear model for developing complex interventions?
Theory ---> Modelling ---> Exploratory trial ---> Definitive RCT ---> Long term implementation.
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What is the process of the interactive model for developing complex interventions?
Development ---> Feasibility and piloting ---> Evaluation ---> Implementation.
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What are the stages of designing a cognitive therapy?
Identify core abnormality in disorder ---> Construct theoretical account to explain abnormality ---> Test hypothesis in experimental studies ---> Develop intervention to reverse abnormality ---> Use RCTs ---> Use dismantelling studies.
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Card 2

Front

What are longitudinal studies used for?

Back

Determining if a mechanism at time one predicts symptom severity at time two, even when controlling for severity at time one.

Card 3

Front

What are manipulation designs used for?

Back

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Card 4

Front

What do mediation methods consist of?

Back

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Card 5

Front

What do dismantling studies consist of?

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