Articles which compare practical examples of different methods of involving users are rare, so the paper by van Wersch and Eccles¹ in this issue of Quality in Health Care is of particular interest. It examines four methods of involving patients in the development of clinical guidelines which, in itself, is an area that has received relatively little attention. The four methods tested were:

• inclusion of individual patients in guideline development groups;

• “one off” meeting with patients;

• series of workshops with patients;

• inclusion of a patient advocate in guideline development groups.

The findings in this specialised area support the results of evaluations of user involvement initiatives more generally, although they also raise a number of questions. For example, at a workshop on user involvement in R&D organised by the West Midlands Regional Office in December 2000, all speakers—including the director of the Consumers in NHS Research Support Unit—drew attention to the time consuming and resource intensive nature of involving users in research in a way that enabled them to make a meaningful contribution, so it is no surprise to see the authors make the same observation.

Inevitably …