Rapid, responsive, relevant (R3) research: a call for a rapid learning health research enterprise

Abstract

Our current health research enterprise is painstakingly slow and cumbersome, and its results seldom translate into practice. The slow pace of health research contributes to findings that are less relevant and potentially even obsolete. To produce more rapid, responsive, and relevant research, we propose approaches that increase relevance via greater stakeholder involvement, speed research via innovative designs, streamline review processes, and create and/or better leverage research infrastructure. Broad stakeholder input integrated throughout the research process can both increase relevance and facilitate study procedures. More flexible and rapid research designs should be considered before defaulting to the traditional two‐arm randomized controlled trial (RCT), but even traditional RCTs can be designed for more rapid findings. Review processes for grant applications, IRB protocols, and manuscript submissions can be better streamlined to minimize delays. Research infrastructures such as rapid learning systems and other health information technologies can be leveraged to rapidly evaluate new and existing treatments, and alleviate the extensive recruitment delays common in traditional research. These and other approaches are feasible but require a culture shift among the research community to value not only methodological rigor, but also the pace and relevance of research.

Optimizing behavioral health interventions with single-case designs: from development to dissemination

“…Many researchers have argued that our research tools have become limited, particularly in the domain of behavioral health interventions [1][2][3][4][5][6][7][8][9]. The reasons for their arguments vary, but include an overreliance on randomized controlled trials, the slow pace and high cost of such trials, and the lack of attention to individual differences.…”

“…During development, SCDs may obviate some logistical issues in using between-group designs to conduct initial efficacy testing [3,8]. Specifically, the costs and duration needed to conduct a SCD to establish preliminary efficacy would be considerably lower than traditional randomized designs.…”

“…Specifically, the costs and duration needed to conduct a SCD to establish preliminary efficacy would be considerably lower than traditional randomized designs. Riley and colleagues [8] noted that randomized trials take approximately 5.5 years from the initiation of enrollment to publication, and even longer from the time a grant application is submitted. In addition to establishing whether a treatment works, SCDs have the flexibility to efficiently address which parameters and components are necessary or optimal.…”

Digital Technology and Mental Health Interventions: Opportunities and Challenges

“…Also, the preferred RCT design may not always be the best choice in testing an intervention due to the length of time they require as well as the rigidity of design. As noted in recent reviews on mobile interventions (Kumar et al, 2013;Mohr et al, 2013;Riley et al, 2013), the technology is advancing so quickly that research cannot keep up with development. Other ways of assessing impact besides RCTs, includes continuously evaluating interventions as they are developed and incorporating novel research designs that can take advantage of advanced statistical methods.…”

Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study

“…Many practice-based research networks (PBRNs) function as learning communities that strive to improve quality of care in member practices [1][2][3][4]. Some provide resources to support dissemination and implementation, such as performance feedback, identification and spread of best indigenous practices, academic detailing, and practice facilitation, evidence-based strategies that have been tested and refined in Ontario, Canada, the Oklahoma Physicians Resource/Research Network (OKPRN), and in other primary care settings [5][6][7][8][9][10][11].…”