Making trials matter: pragmatic and explanatory trials and the problem of applicability

Shaun Treweek, Merrick Zwarenstein

    Research output: Contribution to journalReview article

    267 Citations (Scopus)

    Abstract

    Randomised controlled trials are the best research design for decisions about the effect of different interventions but randomisation does not, of itself, promote the applicability of a trial's results to situations other than the precise one in which the trial was done. While methodologists and trialists have rightly paid great attention to internal validity, much less has been given to applicability.

    This narrative review is aimed at those planning to conduct trials, and those aiming to use the information in them. It is intended to help the former group make their trials more widely useful and to help the latter group make more informed decisions about the wider use of existing trials. We review the differences between the design of most randomised trials (which have an explanatory attitude) and the design of trials more able to inform decision making (which have a pragmatic attitude) and discuss approaches used to assert applicability of trial results.

    If we want evidence from trials to be used in clinical practice and policy, trialists should make every effort to make their trial widely applicable, which means that more trials should be pragmatic in attitude.

    Original languageEnglish
    Article number37
    Pages (from-to)-
    Number of pages9
    JournalTrials
    Volume10
    DOIs
    Publication statusPublished - 3 Jun 2009

    Keywords

    • Randomised controlled trials

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