• Trisha Greenhalgh.
• Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK.
• J Eval Clin Pract. 2025 Feb 1; 31 (1): e14263e14263.

AbstractThis commentary on Sturmberg and Mercuri's paper 'Every Problem is Embedded in a Greater Whole' [1] argues that those authors have approached complexity from a largely mathematical perspective, drawing on the work of Sumpter. Whilst such an approach allows us to challenge the simple linear causality assumed in randomised controlled trials, it is itself limited. Mathematical complexity can explain nonlinearity and network effects but it cannot explain human values. It overlooks, for example, how science itself is historically and culturally shaped and how values-driven misunderstandings and conflicts are inevitable when people with different world views come together to try to solve a problem. This paper argues that the mathematical version of complexity thinking is necessary but not sufficient in medical research, and that we need to enhance such thinking further with attention to human values.© 2024 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.

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