Pragmatic vs. explanatory: An adaptation of the PRECIS tool helps to judge the applicability of systematic reviews for daily practice

被引：48

作者：

Koppenaal, Tjarco ^{[1
,2
]}

Linmans, Joris ^{[1
]}

Knottnerus, J. Andre ^{[1
]}

Spigt, Mark ^{[1
]}

机构：

[1] Maastricht Univ, CAPHRI, Dept Gen Practice, NL-6200 MD Maastricht, Netherlands

[2] Eindhoven Corp, Primary Hlth Care Ctr, NL-5622 AB Eindhoven, Netherlands

来源：

JOURNAL OF CLINICAL EPIDEMIOLOGY | 2011年 / 64卷 / 10期

关键词：

Systematic review; Randomized controlled trials; Pragmatic trial; Clinical trial methodology; Lifestyle intervention; Policy-making; CORONARY-ARTERY-DISEASE; RANDOMIZED-TRIAL; GENERAL-PRACTICE; DISTINGUISHED EFFICACY; CALCIUM-ANTAGONIST; KIDNEY-DISEASE; HEART-DISEASE; HYPERTENSION; DESIGN; LIFE;

D O I：

10.1016/j.jclinepi.2010.11.020

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Objective: The Pragmatic Explanatory Continuum Indicator Summary (PRECIS) tool was designed to classify randomized clinical trials (RCT) as being more pragmatic or explanatory. We modified the PRECIS tool (called PRECIS-Review tool [PR-tool]) to grade individual trials and systematic reviews of trials. This should help policy makers, clinicians, researchers, and guideline developers to judge the applicability of individual trials and systematic reviews. Study Design and Setting: To illustrate the usefulness and applicability of the PR-tool, we applied it to two systematic reviews. Each included RCT was scored on the 10 PRECIS domains on a scale of 1-5. After this scoring, a 10-domain average for each individual trial and for the systematic review a single domain average and an overall average was calculated. Results: One review was more pragmatic with an average score of 3.7 (range, 2.9-4.6) on our PR-tool, whereas the other review was more explanatory with an average score of 1.9 (range, 1.1-3.3). The results also suggest that the included studies within each systematic review were rather uniform in their approach, although some domains seemed more prone to heterogeneity. Conclusion: The PR-tool provides a useful estimate that gives insight by estimating quantitatively how pragmatic each RCT in the review is, which methodological domains are pragmatic or explanatory, and how pragmatic the review is. (C) 2011 Elsevier Inc. All rights reserved.

引用

页码：1095 / 1101

页数：7

共 44 条

[1]

[Anonymous], 1985, J Hypertens, V3, P379

[2]

[Anonymous], 1995, BMJ, V310, P1099

[3]

BARON JA, 1990, BRIT J GEN PRACT, V40, P137

[4]

BERGLUND G, 1986, ACTA MED SCAND, V220, P419

[5]

BUHLER FR, 1984, EUR J CLIN PHARMACOL, V27, P379

[6] RANDOMIZED TRIAL OF TREATMENT OF HYPERTENSION IN ELDERLY PATIENTS IN PRIMARY CARE [J].

COOPE, J ;

WARRENDER, TS .

BRITISH MEDICAL JOURNAL, 1986, 293 (6555) :1145-1151

[7]

Dahlof B, 1997, AM J HYPERTENS, V10, P705

[8] Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE):: a randomised trial against atenolol [J].

Dahlöf, B ;

Devereux, RB ;

Kjeldsen, SE ;

Julius, S ;

Beevers, G ;

de Faire, U ;

Fyhrquist, F ;

Ibsen, H ;

Kristiansson, K ;

Lederballe-Pedersen, O ;

Lindholm, LH ;

Nieminen, MS ;

Omvik, P ;

Oparil, S ;

Wedel, H .

LANCET, 2002, 359 (9311) :995-1003

[9] Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA):: a multicentre randomised controlled trial [J].

Dahlöf, B ;

Sever, PS ;

Poulter, NR ;

Wedel, H ;

Beevers, DG ;

Caulfield, M ;

Collins, R ;

Kjeldsen, SE ;

Kristinsson, A ;

McInnes, GT ;

Mehlsen, J ;

Nieminen, M ;

O'Brien, E ;

Östergren, J .

LANCET, 2005, 366 (9489) :895-906

[10] Effectiveness of counselling patients on physical activity in general practice: cluster randomised controlled trial [J].

Elley, CR ;

Kerse, N ;

Arroll, B ;

Robinson, E .

BRITISH MEDICAL JOURNAL, 2003, 326 (7393) :793-796

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