Evidence map›Paper›PMID 40739244›Full record

ArticleTrials2025

Process evaluations nested in randomised controlled trials of complex interventions: a scoping review of approaches and reporting.

Maartje Kletter, Gill Norman, Jo Dumville, Paul Wilson

Abstract readScoping Review
In one paragraph

Article in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Maartje KletterDivision of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PL, UK. maartje.kletter@manchester.ac.uk.ORCID http://orcid.org/0000-0001-5931-0976
Gill NormanNIHR Innovation Observatory, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
Jo DumvilleDivision of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
Paul WilsonDivision of Population Health, Health Services Research & Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe United Kingdom Medical Research Council (MRC) guidance for complex interventions recommends the nesting of process evaluations in randomised controlled trials (RCTs) of complex interventions. To date, there has been limited review of how the MRC guidance has been operationalised in RCTs of complex interventions.

objectivesThis scoping review aimed to identify how process evaluations nested in RCTs on complex interventions have been conducted and reported since the 2015 publication of MRC guidance.

methodsWe identified articles in PubMed and Scopus that cited the 2015 main journal article on the MRC guidance and applied an RCT filter to these articles. Studies reporting on RCT nested process evaluations in any field of health or social care were included. Data was extracted about study details, process evaluation study design, including methods used for data collection, data analyses, integration with RCT data and use of theory in process evaluation design.

resultsWe identified 160 RCTs and 53 pilot/feasibility RCTs. Most process evaluations included a combination of qualitative and quantitative data collection methods, either triangulated (mixed method studies) or not (multi-method studies). Most studies did not report the use of theory in shaping how the process evaluation was designed. Common methods for data analysis included descriptive statistics and thematic analysis for quantitative and qualitative studies respectively. There was limited triangulation of process evaluation data with RCT outcomes.

conclusionsWhilst process evaluations can be helpful in explaining outcomes of RCT interventions and subsequent implementation of these intentions, information gathered from process evaluations is often not fully reported in papers. There are currently no suitable reporting guidelines for process evaluations linked to RCTs; work to develop such guidelines, potentially as a StaRI checklist extension, would be valuable.

Indexed as

Process Assessment, Health CareRandomized Controlled Trials as TopicResearch DesignHumansProcess evaluationsRandomised controlled trialsScoping review

Identifiers

PMID40739244
PMCPMC12312533

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.