Evaluating the Impact of Clinical Trials: Applying and Extending the Payback Framework

This article reports on an evaluation study of Breast Cancer Trials, an Australian non-profit cancer research organisation, using the Payback Framework. The organisation’s impact over a 40 year period was assessed through a mixed methods design, assessing impact across the five dimensions of the framework: knowledge production, informing policy and product development, the research system, health and health sector benefits, and broader economic benefits. The evaluation found that Breast Cancer Trials created impact in each of these five traditional dimensions. Interestingly, findings highlighted the importance of a sixth dimension – social benefits, in particular psycho-social benefits, involving connections and supportive interactions for various individuals and communities. These benefits included and resulted from improved health literacy and mental health of patients’ family, and personal impact on researchers and others involved in clinical trials, representing a significant dimension for Breast Cancer Trials and potentially other organisations wishing to comprehensively evaluate impact. Impact evaluation is an ongoing endeavour and is strengthened by good design, stakeholder engagement, and accountability. We contend that using an extended Payback Framework to include a sixth dimension, social benefits , allows organisations to reflect more broadly on the significance, scope, and impact of their work, incorporating the wide range of impacts on various stakeholder groups.