World’s First Randomised Trial of Public Involvement in Health Care and Policy Decisions

Evaluating the effects of public and patient involvement in priority setting in health care is notoriously tricky. However, two recent studies reported on a cluster RCT of enhanced public involvement among six health authorities in Canada.[1] [2] The results favoured the intervention, in that the priorities selected were different across the two groups and “Professionals’ choices moved toward indicators prioritized by the public (eg, access), and public representatives’ choices moved toward indicators prioritized by professionals (eg, self-care support).” A great strength of the study is the use of mixed methods advocated by CLAHRC WM – actually by all CLAHRCs. The public involvement was very carefully implemented with thorough induction of public representatives and moderation of the discussions, and the public representatives were selected because they were thought to have legitimacy and to represent different interests. These are landmark papers. In CLARHC WM what gets studied is what is implemented. The corollary is that there is no point in asking people what they want to research without also asking them what they think should be implemented. We therefore ensure that the members of the public who advise on the research are largely the same as those advising on the service.

— Richard Lilford, CLAHRC WM Director


  1. Boivin A, Lehoux P, Burgers J, Grol R. What Are the Key Ingredients for Effective Public Involvement in Health Care Improvement and Policy Decisions? A Randomized Trial Process Evaluation. Milbank Q. 2014. 92(2):319-50.
  2. Boivin A, Lehoux P, Lacombe R, Burgers J, Grol R. Involving patients in setting priorities for healthcare improvement: a cluster randomized trial. Implement Sci. 2014; 9:24.

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