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A new pyramid of research knowledge for the NHS

Lookup NU author(s): Dr Derek Milne, Professor Mark FreestonORCiD, Dr Roger Paxton


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Background: Although the research and development (R&D) initiative in the NHS clearly encompasses a wide range of research activities, existing guidance emphasizes efficacy (explanatory) research, namely the generation of new knowledge under rigorous scientific conditions. Aims: We argue that this needs to be counter-balanced with an equivalent emphasis on effectiveness (pragmatic) research, being those activities that improve the effects of new knowledge within the NHS. Method: Treating the efficacy framework for complex interventions as one half of a research knowledge pyramid, we set out a parallel effectiveness (service improvement/evaluation) framework. Results: With the aid of local examples, we show how this pyramid approach can facilitate R&D training, specifically in relation to clinical psychology. Conclusions: Our pyramid of research knowledge redresses the current emphasis on explanatory research and indicates how we can apply a more balanced model, hopefully aiding professionals who teach or practise effectiveness research. Declaration of interest: None.

Publication metadata

Author(s): Milne DL, Freeston MH, Paxton R, James I, Cooper M, Knibbs J

Publication type: Review

Publication status: Published

Journal: Journal of Mental Health

Year: 2008

Volume: 17

Issue: 5

Pages: 509-519

ISSN (print): 0963-8237

ISSN (electronic): 1360-0567


DOI: 10.1080/09638230701530259