Fig. 1

The research improvement cube. a The costs (x axis), potential benefits (y axis) and our certainty in these estimates (z axis) can be portrayed in three dimensional space. b An intervention which is known, with confidence, to have high cost and low benefit is unlikely to be implemented. c An intervention for which there is low certainty in costs of benefits, but a suggestion of low cost and high benefit, might be suitable for implementation with audit to establish if the expected changes occur