Developing Realist Economic Evaluation Methods (REEM) and Guidance to Evaluate the Impact, Costs, and Consequences of Complex Interventions
Creators: name: Dalkin, Sonia
name: Bate, Angela
Publisher: name: Open Science Framework
Year: 2022
Subjects: subject: Medicine and Health Sciences
subject: Social and Behavioral Sciences

description: It is increasingly recognised that the ‘big problems’ in health and social care require well-designed complex solutions and robust evaluation, which itself is often complex. Realist evaluations were designed to take account of that complexity, offering an explanation of ‘what works, for who, in which circumstances and why?’. Concurrently, policymakers and research funders require economic appraisals to accompany evaluations of complex interventions, to inform difficult decisions in the context of resource scarcity. However, economic evaluation methods often ignore context and do not capture variations in resource use or outcomes across groups, or recognise the implications this may have for the relationship between resource use and outcomes. Additionally, realist evaluations do not tend to explicitly capture the economic consequences of interventions. This research will develop realist economic evaluation methods (REEM) and guidance to better understand and evaluate the costs and consequences of complex interventions. It will bring together realist and economic evaluation to enable evaluators to establish what works, for whom, in which circumstances, whist integrating better understanding of costs and consequences (including opportunity cost). This research addresses the following questions in three phases: • Phase 1 (Months 0-12): What are the theoretical, methodological and practical similarities and differences between realist and economic evaluations? This phase will use literature scoping, online discussion boards (including short activities), and facilitated virtual meetings to develop provisional REEM guidance for piloting. • Phase 2 (Months 13-30 months): What lessons can we learn from using REEM in practice to improve it? This phase will pilot REEM and investigate its feasibility in research across three evaluations. • Phase 3 (Months 31–36): How can we use empirical and expert knowledge to produce consensus REEM guidance? This phase will use an online Delphi method followed by a Consensus Development Conference to agree the core elements of REEM and produce finalised guidance. The outputs from this research will be REEM guidance, a checklist, and summary notes for use by PPIE members. These outputs will allow REEM to be utilised by academics and scrutinised by research funders. Additional outputs include: peer reviewed academic journal articles, conference presentations, webinars for research funders, policy makers and commissioners. Short term impact will be facilitated through: stakeholder involvement from the outset of the research, development of international academic networks, and established international academic reach. Long term impact will include the use of REEM to: make better-informed commissioning and policy decisions; reduce research waste, and better target interventions to those that need them.