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Complex intervention modelling should capture the dynamics of adaptation

Overview of attention for article published in BMC Medical Research Methodology, May 2016
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (78th percentile)

Mentioned by

14 tweeters


15 Dimensions

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97 Mendeley
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Complex intervention modelling should capture the dynamics of adaptation
Published in
BMC Medical Research Methodology, May 2016
DOI 10.1186/s12874-016-0149-8
Pubmed ID

James Greenwood-Lee, Penelope Hawe, Alberto Nettel-Aguirre, Alan Shiell, Deborah A. Marshall


Complexity has been linked to health interventions in two ways: first as a property of the intervention, and secondly as a property of the system into which the intervention is implemented. The former recognizes that interventions may consist of multiple components that act both independently and interdependently, making it difficult to identify the components or combinations of components (and their contexts) that are important mechanisms of change. The latter recognizes that interventions are implemented in complex adaptive systems comprised of intelligent agents who modify their behaviour (including any actions required to implement the intervention) in an effort to improve outcomes relative to their own perspective and objectives. Although an intervention may be intended to take a particular form, its implementation and impact within the system may deviate from its original intentions as a result of adaptation. Complexity highlights the challenge in developing interventions as effective health solutions. The UK Medical Research Council provides guidelines on the development and evaluation of complex interventions. While mathematical modelling is included in the guidelines, there is potential for mathematical modeling to play a greater role. The dynamic non-linear nature of complex adaptive systems makes mathematical modelling crucial. However, the tendency is for models of interventions to limit focus on the ecology of the system - the 'real-time' operation of the system and impacts of the intervention. These models are deficient by not modelling the way the system reacts to the intervention via agent adaptation. Complex intervention modelling needs to capture the consequences of adaptation through the inclusion of an evolutionary dynamic to describe the long-term emergent outcomes that result as agents respond to the ecological changes introduced by intervention in an effort to produce better outcomes for themselves. Mathematical approaches such as those found in economics in evolutionary game theory and mechanism design can inform the design and evaluation of health interventions. As an illustration, the introduction of a central screening clinic is modeled as an example of a health services delivery intervention. Complexity necessitates a greater role for mathematical models, especially those that capture the dynamics of human actions and interactions.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 97 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Canada 2 2%
France 1 1%
United Kingdom 1 1%
Unknown 93 96%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 19 20%
Researcher 16 16%
Other 10 10%
Student > Master 10 10%
Student > Doctoral Student 7 7%
Other 17 18%
Unknown 18 19%
Readers by discipline Count As %
Medicine and Dentistry 29 30%
Nursing and Health Professions 10 10%
Psychology 6 6%
Social Sciences 6 6%
Computer Science 5 5%
Other 13 13%
Unknown 28 29%

Attention Score in Context

This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 August 2016.
All research outputs
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Outputs from BMC Medical Research Methodology
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Outputs of similar age
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Outputs of similar age from BMC Medical Research Methodology
of 1 outputs
Altmetric has tracked 20,856,737 research outputs across all sources so far. Compared to these this one has done well and is in the 82nd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,859 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.5. This one has gotten more attention than average, scoring higher than 66% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 278,005 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 78% of its contemporaries.
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