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Why is it that in spite of all the health policy reforms, clinical practice innovations, increasing intersectoral interdependencies and new medical and information technologies, so little has changed in the way we research and evaluate health care? Don't these changes cry out for new ways of being studied and appraised? And don't our approaches to clinical practice innovation cry out for being reinvented too? Surely, we cannot continue to wheel out research and evaluation paradigms, improvement approaches and methods that were designed for 20th century problems and 20th century health care,...