A pragmatic-explanatory continuum indicator summary (PRECIS): a tool to help trial designers.
OBJECTIVE
To propose a tool to assist trialists in making design decisions that are consistent with their trial's stated purpose.


METHODS
Randomized trials have been broadly categorized as either having a pragmatic or explanatory attitude. Pragmatic trials seek to answer the question, "Does this intervention work under usual conditions?," whereas explanatory trials are focused on the question, "Can this intervention work under ideal conditions?" Design decisions make a trial more (or less) pragmatic or explanatory, but no tool currently exists to help researchers make the best decisions possible in accordance with their trial's primary goal. During the course of two international meetings, participants with experience in clinical care, research commissioning, health care financing, trial methodology, and reporting defined and refined aspects of trial design that distinguish pragmatic attitudes from explanatory.


RESULTS
We have developed a tool (called PRECIS) with 10 key domains and which identifies criteria to help researchers determine how pragmatic or explanatory their trial is. The assessment is summarized graphically.


CONCLUSIONS
We believe that PRECIS is a useful first step toward a tool that can help trialists to ensure that their design decisions are consistent with the stated purpose of the trial.
Dalla Lana School of Public Health, University of Toronto, Ontario, Canada. kevin.thorpe@utoronto.ca
Kevin E
KE
Thorpe
Merrick
M
Zwarenstein
Andrew D
AD
Oxman
Shaun
S
Treweek
Curt D
CD
Furberg
Douglas G
DG
Altman
Sean
S
Tunis
Eduardo
E
Bergel
Ian
I
Harvey
David J
DJ
Magid
Kalipso
K
Chalkidou
D002986:Clinical Trials as Topic / Q000379:methods; D032921:Consensus; D003657:Decision Making; D006801:Humans; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012107:Research Design