Table 2

Phases of the IDEAL framework22

IdeaInitial report
 Innovation may be planned, accidental or forced
 Focus on explanation and description
DevelopmentRapid iterative modification of innovation
 Small experience from one centre
 Focus on technical details and feasibility
ExplorationInnovation now more stable
 Replication by others
 Focus on assessing potential benefits and adverse effects
AssessmentInnovation gaining wide acceptance
 Considered as possible replacement for current treatment, ways of working
Focus on comparative evaluation against current standards or best practice
Long-term monitoringLong-term surveillance of the innovation
 Focus on monitoring late and rare problems, changes in use