Mapping review of ‘proof-of-concept’ in mental health implementation research using the TRL framework: a need for a better focus and conceptual clarification

• Published in: BMJ open 2024-08, Vol.14 (8), p.e080078
• Main Authors: Woods, Cindy E, Lukersmith, Sue, Salvador-Carulla, Luis
• Format: Article
• Language: English
• Subjects: Feasibility studies; Health; Humans; Implementation Science; Intervention; MENTAL HEALTH; Mental Health Services - organization & administration; Mental Health Services - standards; Pilot projects; Public health; Systematic Review
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-080078

BackgroundProof-of-concept (PoC) development is a key step in implementation sciences. However, there is a dearth of studies in this area and the use of this term in health and social sciences is ambiguous.ObjectiveThe objective was to remove the ambiguity surrounding the PoC and pilot study stage in the research development process using a standard system to rate the development of projects and applications provided by the Technology Readiness Levels (TRL) framework.DesignMapping review and critical analysis using TRL as the standard measure.Search strategy and charting methodPubMed and PsycInfo databases were searched for papers that reported PoC studies of mental health interventions up to August 2023. Data were extracted, described and tabulated.Eligibility criteriaIncluded were PoC studies in mental health implementation research. Exclusion criteria were research relating to biomedical (drugs) development, neurocognitive tools, neuropsychology, medical devices, literature reviews or discussion papers or that did not include the term ‘proof-of-concept’ in the title, abstract or text.ResultsFrom the 83 citations generated from the database search, 22 studies were included in this mapping review. Based on the study title, abstract and text, studies were categorised by research development stage according to the TRL framework. This review showed 95% of the studies used PoC incorrectly to describe the development stage of their research but which were not at this specific level of project development.ConclusionsThe TRL was a useful reference framework to improve terminological clarity around the term ‘proof-of-concept’ in implementation research. To extend the use of TRL in implementation sciences, this framework has now been adapted and validated to a health and social science-related research context accompanied by a health-related glossary of research process terms and definitions to promote a common vocabulary and shared understanding in implementation sciences.