Bhattacharyya Onil, Reeves Scott, Garfinkel Susan, Zwarenstein Merrick
Department of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.
Implement Sci. 2006 Feb 23;1:5. doi: 10.1186/1748-5908-1-5.
The Improved Clinical Effectiveness through Behavioural Research Group (ICEBeRG) authors assert that a key weakness in implementation research is the unknown applicability of a given intervention outside its original site and problem, and suggest that use of explicit theory offers an effective solution. This assertion is problematic for three primary reasons. First, the presence of an underlying theory does not necessarily ease the task of judging the applicability of a piece of empirical evidence. Second, it is not clear how to translate theory reliably into intervention design, which undoubtedly involves the diluting effect of "common sense." Thirdly, there are many theories, formal and informal, and it is not clear why any one should be given primacy. To determine whether explicitly theory-based interventions are, on average, more effective than those based on implicit theories, pragmatic trials are needed. Until empirical evidence is available showing the superiority of theory-based interventions, the use of theory should not be used as a basis for assessing the value of implementation studies by research funders, ethics committees, editors or policy decision makers.
通过行为研究提高临床效果小组（ICEBeRG）的作者断言，实施研究的一个关键弱点是特定干预措施在其原始地点和问题之外的适用性未知，并建议使用明确的理论提供有效的解决方案。这一断言存在三个主要问题。首先，存在潜在理论并不一定能减轻判断一条实证证据适用性的任务。其次，尚不清楚如何将理论可靠地转化为干预设计，这无疑涉及“常识”的稀释效应。第三，有许多正式和非正式的理论，不清楚为什么要赋予任何一种理论首要地位。为了确定基于明确理论的干预措施平均而言是否比基于隐含理论的干预措施更有效，需要进行务实试验。在有实证证据表明基于理论的干预措施具有优越性之前，研究资助者、伦理委员会、编辑或政策决策者不应将理论的使用作为评估实施研究价值的依据。
