ArticleBMC medical research methodology2017
Pragmatic clinical trials embedded in healthcare systems: generalizable lessons from the NIH Collaboratory.
Article in BMC medical research methodology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03713333 (Implementation of High Definition Screening Using Handheld Imaging and Digital Health Technologies Within a Learning Health System to Identify Cardiovascular Disease at the Point-of-care), which is not on this map. Cited by 115 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.
Implementation of High Definition Screening Using Handheld Imaging and Digital Health Technologies Within a Learning Health System to Identify Cardiovascular Disease at the Point-of-care: The ASE-INNOVATE Program
Who cites it
115 citing papers in PubMed, 183 citations in OpenAlex.
- Reducing Work-Related Screen-Time in Healthcare Workers During Leisure Time (REDUCE SCREEN) - A Randomized Controlled Trial.Journal of medical systems · 2026Trial
- Patient monitoring in a pragmatic, multicenter trial of incremental hemodialysis: early experience from the TwoPlus randomized controlled trial.BMC nephrology · 2025Trial
- The dementia care study (D-CARE): Recruitment strategies and demographic characteristics of participants in a pragmatic randomized trial of dementia care.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Trial
- Partner engagement for planning and development of non-pharmacological care pathways in the AIM-Back trial.Clinical trials (London, England) · 2023Trial
- The promises and challenges of pragmatism: lesson from of a recent clinical trial.Annals of translational medicine · 2022Trial
- Findings of Sequential Pilot Trials of Aliviado Dementia Care to Inform an Embedded Pragmatic Clinical Trial.The Gerontologist · 2022Trial
- Results of the CHlorhexidine Gluconate Bathing implementation intervention to improve evidence-based nursing practices for prevention of central line associated bloodstream infections Study (CHanGing BathS): a stepped wedge cluster randomized trial.Implementation science : IS · 2021Trial
- Preventing maternal mental health disorders in the context of poverty: pilot efficacy of a dyadic intervention.American journal of obstetrics & gynecology MFM · 2020Trial
- Pragmatic Trials in Genomic Medicine: The Integrating Pharmacogenetics In Clinical Care (I-PICC) Study.Clinical and translational science · 2020Trial
- The TiME Trial: A Fully Embedded, Cluster-Randomized, Pragmatic Trial of Hemodialysis Session Duration.Journal of the American Society of Nephrology : JASN · 2019Trial
- Assessing Electronic Health Record-Derived Outcomes in a Pragmatic Weight Gain Prevention Trial: Effects, Variability, and Implications for Future Trials.The Journal of cardiovascular nursingTrial
- The design of embedded pragmatic clinical trials: methodological developments and statistical lessons learned from the first cycle of the NIA IMPACT collaboratory.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Trial-Based Economic Evaluations Conducted alongside Studies Embedded in Australian Healthcare Services and Programs: A Scoping Review.PharmacoEconomics - open · 2026Review
- A Framework of Institutional Obligations for Pragmatic Clinical Trials.The American journal of bioethics : AJOB · 2026Article
- Real-World Evidence: Better than Nothing or the Future? A Perspective on Clinical Evidence Generation in Interventional Oncology.Cardiovascular and interventional radiology · 2026Review
- Lessons Learned From the Implementation of a Pragmatic Trial Evaluating Non-Pharmacological Approaches to Dementia Care in US Nursing Homes.Journal of evaluation in clinical practice · 2026Article
- Rethinking ethical reflexivity and oversight in health research through an ecosystem approach: A workshop report.Research ethics · 2026Article
- Research on the road: Partnering with community emergency medical services to expand access to clinical trials.Journal of clinical and translational science · 2026Article
- Embedding Implementation Science in Clinical Trials: A Framework for Academic-Life Science Partnerships.Pharmaceutical medicine · 2025Review
- A framework for health systems to assess and prioritize participation in pragmatic clinical trials.Learning health systems · 2025Article
55 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 12 institutions in 1 country.
Funding
Abstract
backgroundThe clinical research enterprise is not producing the evidence decision makers arguably need in a timely and cost effective manner; research currently involves the use of labor-intensive parallel systems that are separate from clinical care. The emergence of pragmatic clinical trials (PCTs) poses a possible solution: these large-scale trials are embedded within routine clinical care and often involve cluster randomization of hospitals, clinics, primary care providers, etc. Interventions can be implemented by health system personnel through usual communication channels and quality improvement infrastructure, and data collected as part of routine clinical care. However, experience with these trials is nascent and best practices regarding design operational, analytic, and reporting methodologies are undeveloped.
methodsTo strengthen the national capacity to implement cost-effective, large-scale PCTs, the Common Fund of the National Institutes of Health created the Health Care Systems Research Collaboratory (Collaboratory) to support the design, execution, and dissemination of a series of demonstration projects using a pragmatic research design.
resultsIn this article, we will describe the Collaboratory, highlight some of the challenges encountered and solutions developed thus far, and discuss remaining barriers and opportunities for large-scale evidence generation using PCTs.
conclusionA planning phase is critical, and even with careful planning, new challenges arise during execution; comparisons between arms can be complicated by unanticipated changes. Early and ongoing engagement with both health care system leaders and front-line clinicians is critical for success. There is also marked uncertainty when applying existing ethical and regulatory frameworks to PCTS, and using existing electronic health records for data capture adds complexity.
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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.