title: Pragmatic vs. explanatory: an adaptation of the PRECIS tool helps to judge the applicability of systematic reviews for daily practice.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of General Practice, CAPHRI, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Tjarco
authors.initials: T
authors.lastname: Koppenaal
authors.forename: Joris
authors.initials: J
authors.lastname: Linmans
authors.forename: J André
authors.initials: JA
authors.lastname: Knottnerus
authors.forename: Mark
authors.initials: M
authors.lastname: Spigt
mesh_terms: D002986:Clinical Trials as Topic; D003661:Decision Support Techniques; D012107:Research Design / Q000592:standards; D012196:Review Literature as Topic