Studying Complexity is Complex

T his supplement contains 9 articles that arose from a Department of Veterans Affairs sponsored State of the Art (SOTA) conference "Managing Complexity in Chronic Care."It is appropriate that these articles appear in the Journal of General Internal Medicine.Advocates for general internal medicine as a specialty often mention the care of complex chronically ill patients as a special competency of General Internists. 1 Moreover, the Society of General Internal Medicine and its members have been leaders in recognizing and addressing the research and policy importance of this large patient population. 2 The editors of JGIM believe that this supplement provides critical early exposure for research topics that will appeal to funders such as the VA, other federal agencies, and foundations like the Robert Wood Johnson Foundation who wish to encourage research regarding the care for this challenging, but growing population.During the months spent overseeing and contributing to the peer review of the articles included in this supplement, we were struck that some of our usual editorial criteria were difficult to apply.It appeared to us that the science of studying the chronic care of complex patients required significant changes in our concept of "important research results."Three of the articles, by Luck et al, Sevick et al and Vogeli et al, present reviews of the literature.We were relieved to see that these authors also struggled to identify research that met traditional standards for rigorous methodology.It was interesting that Luck et al, who examine the business case for improving care, were able to find considerable information on patients with