Jon P Nicholl

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Surgery and other invasive therapies are complex interventions, the assessment of which is challenged by factors that depend on operator, team, and setting, such as learning curves, quality variations, and perception of equipoise. We propose recommendations for the assessment of surgery based on a five-stage description of the surgical development process.(More)
OBJECTIVES Many claims are made that complementary medicine use is a substantial and growing part of health-care behaviour. Estimates of practitioner visits in the USA and Australia indicate high levels of use and expenditure. No reliable population-based estimates of practitioner use are available for the UK. METHODS In 1998, a previously piloted postal(More)
OBJECTIVE To evaluate benefits for postnatal women of two psychologically informed interventions by health visitors. DESIGN Prospective cluster trial randomised by general practice, with 18 month follow-up. SETTING 101 general practices in Trent, England. PARTICIPANTS 2749 women allocated to intervention, 1335 to control. INTERVENTION Health(More)
OBJECTIVE To determine whether a short course of traditional acupuncture improves longer term outcomes for patients with persistent non-specific low back pain in primary care. DESIGN Pragmatic, open, randomised controlled trial. SETTING Three private acupuncture clinics and 18 general practices in York, England. PARTICIPANTS 241 adults aged 18-65 with(More)
Research on surgical interventions is associated with several methodological and practical challenges of which few, if any, apply only to surgery. However, surgical evaluation is especially demanding because many of these challenges coincide. In this report, the second of three on surgical innovation and evaluation, we discuss obstacles related to the study(More)
This is the second in a four-part series of articles detailing the epistemology of patient safety research. This article concentrates on issues of study design. It first considers the range of designs that may be used in the evaluation of patient safety interventions, highlighting the circumstances in which each is appropriate. The paper then provides(More)
Surgical innovation is an important part of surgical practice. Its assessment is complex because of idiosyncrasies related to surgical practice, but necessary so that introduction and adoption of surgical innovations can derive from evidence-based principles rather than trial and error. A regulatory framework is also desirable to protect patients against(More)
OBJECTIVES To assess the quality of mixed methods studies in health services research (HSR). METHODS We identified 118 mixed methods studies funded by the Department of Health in England between 1994 and 2004, and obtained proposals and/or final reports for 75. We applied a set of quality questions to both the proposal and report of each study, addressing(More)
OBJECTIVE To assess the cost effectiveness of a community based exercise programme as a population wide public health intervention for older adults. DESIGN Pragmatic, cluster randomised community intervention trial. SETTING 12 general practices in Sheffield; four randomly selected as intervention populations, and eight as control populations. (More)