ArticlePragmatic and observational research2015
Efficacy and effectiveness trials have different goals, use different tools, and generate different messages.
Article in Pragmatic and observational research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 26 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed.
- Promoting Psychological Well-being in Preschoolers Through Mindfulness-based Socio-emotional Learning: A Randomized-controlled Trial.Research on child and adolescent psychopathology · 2024Trial
- Randomized effectiveness Trial of the Family Check-Up versus Internet-delivered Parent Training (iComet) for Families of Children with Conduct Problems.Scientific reports · 2018Trial
- Mighty Men: A Pilot Test of the Feasibility and Acceptability of a Faith-Based, Individually Tailored, Cluster-Randomized Weight Loss Trial for Middle-Aged and Older African American Men.American journal of men's healthTrial
- Real-world data of single-incision laparoscopic appendectomy: a German-wide prospective cohort study among 276 individuals.Annals of medicine and surgery (2012) · 2025Article
- Rectal spacer use and bowel, urinary, and sexual dysfunction diagnosis and related procedures among men receiving prostate radiotherapy: US county-level analysis.World journal of urology · 2025Article
- Effectiveness and prediction of treatment adherence to guided internet-based cognitive behavioral therapy for health anxiety: A cohort study in routine psychiatric care.Internet interventions · 2024Article
- Outcomes comparison of robotic-assisted versus laparoscopic and open surgery for patients undergoing rectal cancer resection with concurrent stoma creation.Surgical endoscopy · 2024Article
- Life, death, and statins: association of statin prescriptions and survival in older general practice patients.Primary health care research & development · 2024Article
- An observational pilot evaluation of the Walk with Ease program for reducing fall risk among older adults.Archives of public health = Archives belges de sante publique · 2023Article
- Recommendations for Designing, Conducting and Reporting Clinical Observational Studies in Homeopathic Veterinary Medicine.Homeopathy : the journal of the Faculty of Homeopathy · 2023Review
- Development of Provisional Acupuncture Guidelines for Pelvic Pain in Endometriosis Using an e-Delphi Consensus Process.Journal of integrative and complementary medicine · 2023Article
- [Covid-19: Twin Method for Verifying Real-World Effectiveness Under Everyday Conditions].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2023Article
- Study protocol: Evaluation of the 'real-world' Farmers Have Hearts - Cardiovascular Health Program.Preventive medicine reports · 2022Article
- A Real-World Study on the Effectiveness and Safety of Pembrolizumab Plus Chemotherapy for Nonsquamous NSCLC.JTO clinical and research reports · 2022Article
- Clinically Meaningful Benefit in Women with Hypoactive Sexual Desire Disorder Treated with Flibanserin.Sexual medicine · 2022Article
- Measuring Health-Related Quality of Life in Randomised Controlled Trials: Expected and Reported Results Do Not Match.Pragmatic and observational research · 2022Article
- Evaluating Effectiveness of Fu's Subcutaneous Needling for the Pain Nature and Quality of Life in Patients with Knee Osteoarthritis: A Study Protocol of Randomized Clinical Trial [Response to Letter].Journal of pain research · 2021Article
- [Hunger for data and patient well-being-health care research on all fronts].Der Urologe. Ausg. A · 2020Article
- Article
- Impediments to clinical application of exercise interventions in the treatment of cardiometabolic disease.Canadian family physician Medecin de famille canadien · 2019Review
Corrections and comments
- Erratum issued
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The discussion about the optimal design of clinical trials reflects the perspectives of theory-based scientists and practice-based clinicians. Scientists compare the theory with published results. They observe a continuum from explanatory to pragmatic trials. Clinicians compare the problem they want to solve by completing a clinical trial with the results they can read in the literature. They observe a mixture of what they want and what they get. None of them can solve the problem without the support of the other. Here, we summarize the results of discussions with scientists and clinicians. All participants were interested to understand and analyze the arguments of the other side. As a result of this process, we conclude that scientists tell what they see, a continuum from clear explanatory to clear pragmatic trials. Clinicians tell what they want to see, a clear explanatory trial to describe the expected effects under ideal study conditions and a clear pragmatic trial to describe the observed effects under real-world conditions. Following this discussion, the solution was not too difficult. When we accept what we see, we will not get what we want. If we discuss a necessary change of management, we will end up with the conclusion that two types of studies are necessary to demonstrate efficacy and effectiveness. Efficacy can be demonstrated in an explanatory, ie, a randomized controlled trial (RCT) completed under ideal study conditions. Effectiveness can be demonstrated in an observational, ie, a pragmatic controlled trial (PCT) completed under real-world conditions. It is impossible to design a trial which can detect efficacy and effectiveness simultaneously. The RCTs describe what we may expect in health care, while the PCTs describe what we really observe.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.