ArticleBMC medical research methodology2019
Pragmatic trials and implementation science: grounds for divorce?
Article in BMC medical research methodology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 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
17 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Strategies to implement evidence-informed decision making at the organizational level: a rapid systematic review.BMC health services research · 2024Pooled it
- Process evaluations of health-promotion interventions in sports settings: a systematic review.Health promotion international · 2023Pooled it
- Attrition one year after starting antiretroviral therapy before and after the programmatic implementation of HIV "Treat All" in Sub-Saharan Africa: a systematic review and meta-analysis.BMC infectious diseases · 2023Pooled it
- A review of trauma and orthopaedic randomised clinical trials published in high-impact general medical journals.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022Pooled it
- From pilot to a multi-site trial: refining the Early Detection of Deterioration in Elderly Residents (EDDIE +) intervention.BMC geriatrics · 2023Trial
- From product to knowledge: the life cycle of health technologies 2.0 as a framework for health system improvement.Frontiers in pharmacology · 2026Article
- Proof of concept studies in mental health systems research: strategy and steps.International journal of mental health systems · 2025Review
- Expanding the pragmatic lens in implementation science: why stakeholder perspectives matter.Implementation science communications · 2025Article
- Similarities and Differences Between Pragmatic Trials and Hybrid Effectiveness-Implementation Trials.Journal of general internal medicine · 2024Article
- Promoting Evidence-Based Practice: The Influence of Novel Structural Change to Accelerate Translational Rehabilitation.Archives of physical medicine and rehabilitation · 2023Article
- Exercise Programming Modelling a Standard of Care Approach Improves Physical Health and Patient-Reported Outcomes in Individuals Living with Breast Cancer: A Pilot Study.Current oncology (Toronto, Ont.) · 2023Article
- Article
- Are morbidity and mortality estimates from randomized controlled trials externally valid? A comparison of outcomes among infants enrolled into an RCT or a cohort study in Botswana.BMC medical research methodology · 2021Observational
- Protocol refinement for a diabetes pragmatic trial using the PRECIS-2 framework.BMC health services research · 2021Article
- Article
- Advancing clinical leadership to improve the implementation of evidence-based practice in surgery: a longitudinal mixed-method study protocol.Implementation science : IS · 2020Article
- Dissemination and implementation research in sports and exercise medicine and sports physical therapy: translating evidence to practice and policy.BMJ open sport & exercise medicine · 2020Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe paper opens with a brief history of two of the major intellectual components of the recent utilitarian turn in clinical research, namely 'pragmatic trials' and 'implementation science'. The two schools of thought developed independently and the paper scrutinises their mutual compatibilities and incompatibilities, asking: i) what do the leading advocates of pragmatic trials assume about the transfer of research findings to real-world practice and ii) what role pragmatic trials can and should play in the evaluation of implementation science strategies.
methodsThe paper utilises 'explication de texte': i) providing a close reading of the inferential logics contained in major published expositions of the two paradigms, and ii) interrogating the conclusions of a pragmatic trial of an intervention providing guidelines on retinal screening aimed at family practitioners.
resultsThe paper is in two parts. Part 1 unearths some significant incommensurability - the pragmatic trial literature retains an antiquated view of knowledge transfer and is overly optimistic about the wide applicability the findings of pragmatic trials to 'real world' conditions. Part 2 of the paper outlines an empirical strategy to better penetrate the mechanisms of knowledge transfer and to tackle the issue of the generalisabilty of research findings in implementation science.
conclusionsPragmatism, classically, is about problem solving and the melding of perspectives. The core research requirement in implementation science is a fundamental shift from the narrow shoulders of pragmatic trials to a model of explanation building based upon a multi-case, multi-method body of evidence.
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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.