有目的和意图地设计以提供者为中心的实现试验:引入PRECIS-2-PS工具。

Wynne E Norton, Kirsty Loudon, David A Chambers, Merrick Zwarenstein
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引用次数: 24

摘要

背景:首先由Schwartz和Lellouch(1967)提出,随机对照试验(rct)可以沿着一个从更具解释性到更实用的连续体进行概念化。前者的目的和意图是在理想环境下测试干预措施,后者的目的和意图是在现实环境中测试干预措施。实用解释性连续指标摘要-2 (PRECIS-2)是一种经过验证的工具,可以帮助研究人员对试验的要素做出决定,以符合连续统一体试验的总体目的和意图。PRECIS-2工具指导了数百个随机对照试验的设计。然而,该工具的一些方面将受益于更清晰的信息,包括将其应用于以提供者为中心的实施试验,而不是以患者为中心的干预试验。本文描述了新开发的PRECIS-2-供应商策略(PRECIS-2- ps)工具,这是PRECIS-2工具的扩展,已被用于测试以供应商为中心的策略。我们详细阐述了可以使以提供者为中心的试验更具解释性或更务实的九个领域,包括资格、招聘、设置、实施资源、提供者策略的灵活性、干预的灵活性、数据收集、主要结果和主要分析。我们详细介绍了研究人员和利益相关者在试验设计阶段发挥的互补作用,并对试验结果在其拟应用的环境中的普遍性产生了影响。结论:PRECIS-2-PS工具旨在帮助研究和实践团队计划以提供者为中心的试验,以反映试验的总体意图和目的。该工具有潜力帮助在一系列试验中推进以提供者为中心的战略科学,其最终目标是促进在试验环境之外采用、整合和可持续性以提供者为中心的战略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Designing provider-focused implementation trials with purpose and intent: introducing the PRECIS-2-PS tool.

Designing provider-focused implementation trials with purpose and intent: introducing the PRECIS-2-PS tool.

Background: First articulated by Schwartz and Lellouch (1967), randomized controlled trials (RCTs) can be conceptualized along a continuum from more explanatory to more pragmatic. The purpose and intent of the former is to test interventions under ideal contexts, and the purpose and intent of the latter is to test interventions in real-world contexts. The PRagmatic Explanatory Continuum Indicator Summary-2 (PRECIS-2) is a validated tool that helps researchers make decisions about the elements of the trial to match the overall purpose and intent of the trial along the continuum. The PRECIS-2 tool has guided the design of hundreds of RCTs. However, a few aspects of the tool would benefit from greater clarity, including its application to provider-focused implementation trials rather than patient-focused intervention trials.

Main text: We describe the newly developed PRECIS-2-Provider Strategies (PRECIS-2-PS) tool, an extension of the PRECIS-2 tool, which has been adapted for trials testing provider-focused strategies. We elaborate on nine domains that can make a provider-focused trial more explanatory or more pragmatic, including eligibility, recruitment, setting, implementation resources, flexibility of provider strategies, flexibility of intervention, data collection, primary outcome, and primary analysis. We detail the complementary roles that researchers and stakeholders play in the trial design phase, with implications for generalizability of trial results to the contexts in which they are intended to be applied.

Conclusions: The PRECIS-2-PS tool is designed to help research and practice teams plan for provider-focused trials that reflect the overall intent and purpose of the trial. The tool has potential to help advance the science of provider-focused strategies across a range of trials, with the ultimate goal of facilitating the adoption, integration, and sustainability of provider-focused strategies outside the context of trials.

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