ArticleJournal of comorbidity2013
Improving the external validity of clinical trials: the case of multiple chronic conditions.
Article in Journal of comorbidity, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 4 of them syntheses that pooled it.
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
19 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- A Systematic Review of Outcomes Related to Nurse Practitioner-Delivered Primary Care for Multiple Chronic Conditions.Medical care research and review : MCRR · 2023Pooled it
- Specific content for collaborative care: a systematic review of collaborative care interventions for patients with multimorbidity involving depression and/or anxiety in primary care.Family practice · 2022Pooled it
- Interventions for improving outcomes in patients with multimorbidity in primary care and community settings.The Cochrane database of systematic reviews · 2021Pooled it
- Interventions for improving outcomes in patients with multimorbidity in primary care and community settings.The Cochrane database of systematic reviews · 2016Pooled it
- Exclusion criteria in clinical trials of treatments for neuropathic pain: a systematic analysis.Frontiers in pain research (Lausanne, Switzerland) · 2026Review
- The silent exclusion: rethinking eligibility and generalizability in clinical trials.The Lancet regional health. Western Pacific · 2025Article
- Development and evaluation of objective trial performance metrics for multisite clinical studies: Experience from the AlcHep Network.Contemporary clinical trials · 2024Article
- Article
- Impacts of Eligibility Criteria on Trial Participants' Age in Alzheimer's Disease Clinical Trials.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2022Article
- Is health research undertaken where the burden of disease is greatest? Observational study of geographical inequalities in recruitment to research in England 2013-2018.BMC medicine · 2020Observational
- Using Real-World Data to Rationalize Clinical Trials Eligibility Criteria Design: A Case Study of Alzheimer's Disease Trials.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2020Article
- Manual therapy for chronic migraine: a pragmatic randomised controlled trial study protocol.Chiropractic & manual therapies · 2019Article
- Mapping of global scientific research in comorbidity and multimorbidity: A cross-sectional analysis.PloS one · 2018Article
- A method of decision analysis quantifying the effects of age and comorbidities on the probability of deriving significant benefit from medical treatments.Journal of comorbidity · 2017Article
- Caring for People With Multiple Chronic Conditions.Preventing chronic disease · 2015Article
- Self-management interventions in patients with long-term conditions: a structured review of approaches to reporting inclusion, assessment, and outcomes in multimorbidity.Journal of comorbidity · 2014Article
- Enhancing research quality and reporting: why theJournal of comorbidity · 2014Article
- Comparing stroke rehabilitation inpatients and clinical trials eligibility criteria: A secondary chart review analysis revealing that most patients could have been excluded from rehabilitation trials based on comorbidity status.Journal of multimorbidity and comorbidityArticle
- Photobiomodulation, Compared to Revascularisation, and Conservative Treatment-What Works for Healing Hard-to-Heal Arterial Leg Ulcers in Older Adults: A Quasi-Experimental Study.Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair SocietyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The U.S. Department of Health and Human Services vision and strategic framework on multiple chronic conditions (MCCs) incorporates recommendations designed to facilitate research that will improve our knowledge about interventions and systems that will benefit individuals with MCCs (or multimorbidity). The evidence base supporting the management of patients with MCCs will be built through intervention trials specifically designed to address multimorbidity and identification of MCCs in participants across the clinical trial range. This article specifically focuses on issues relating to external validity with specific reference to trials involving patients with MCCs. The exclusion of such patients from clinical trials has been well documented. Randomized control trials (RCTs) are considered the "gold standard" of evidence, but may have drawbacks in relation to external validity, particularly in relation to multimorbidity. It may, therefore, be necessary to consider a broader range of research methods that can provide converging evidence on intervention effects to address MCCs. Approaches can also be taken to increase the usefulness of RCTs in general for providing evidence to inform multimorbidity management. Additional improvements to RCTs would include better reporting of inclusion and exclusion criteria and participant characteristics in relation to MCCs. New trials should be considered in terms of how they will add to the existing evidence base and should inform how interventions may work in different settings and patient groups. Research on treatments and interventions for patients with MCCs is badly needed. It is important that this research includes patient-centered measures and that generalizability issues be explicitly addressed. Journal of Comorbidity 2013;3:30-35.
Indexed as
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.