Evidence map›Paper›PMID 31829266›Full record

ArticleTrials2019

Improving the relevance of randomised trials to primary care: a qualitative study investigating views towards pragmatic trials and the PRECIS-2 tool.

Gordon Forbes, Kirsty Loudon, Megan Clinch, Stephanie J C Taylor, Shaun Treweek, Sandra Eldridge

Abstract read
In one paragraph

Article in Trials, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Gordon ForbesKings College London, London, UK. gordon.forbes@kcl.ac.uk.ORCID http://orcid.org/0000-0001-8662-3636
Kirsty LoudonUniversity of Stirling, Stirling, UK.
Megan ClinchQueen Mary, University of London, London, UK.
Stephanie J C TaylorQueen Mary, University of London, London, UK.
Shaun TreweekUniversity of Aberdeen, Aberdeen, UK.
Sandra EldridgeQueen Mary, University of London, London, UK.

Funding

Chief Scientist Office HSRU1
6 · The paper itself

Abstract

backgroundPragmatic trials have been suggested as a way to improve the relevance of clinical trial results to practice. PRECIS-2 (Pragmatic Explanatory Continuum Indicator Summary-2) is a trial design tool which considers how pragmatic a trial is across a number of domains. It is not known whether a pragmatic approach to all PRECIS-2 domains leads to results being more relevant to primary care. The aim of this study was to investigate the views of people with influence on primary care practice towards the design of randomised trials, pragmatic approaches to trial design, and the PRECIS-2 domains.

methodsWe carried out semi-structured interviews with people who influence practice in primary care in the UK. A thematic analysis was undertaken using the framework approach.

resultsWe conducted individual or small group interviews involving an elite sample of 17 individuals. We found that an exclusively pragmatic approach to randomised trials may not always make the results of trials more applicable to primary care. For example, it may be better to have less flexibility in the way interventions are delivered in randomised trials than in practice. In addition, an appropriate balance needs to be struck when thinking about levels of resourcing and the intensity of steps needed to improve adherence in a trial. Across other aspects of a trial's design, for example the population and trial setting, a pragmatic approach was viewed as more appropriate.

conclusionsTo maximize the relevance of research directed at primary care, trials should be conducted with the same populations and settings that are found in primary care. Across other aspects of trials it is not always necessary to match the conditions found in practice.

Indexed as

Attitude of Health PersonnelPatient SelectionPragmatic Clinical Trials as TopicPrimary Health CareAdministrative PersonnelEvidence-Based MedicineHumansInterviews as TopicPolicy MakingQualitative ResearchResearch PersonnelStakeholder ParticipationUnited KingdomPragmatic clinical trialPRECIS-2Primary health careRandomised controlled trial

Identifiers

PMID31829266
PMCPMC6907200

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.