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Pragmatic clinical trials embedded in healthcare systems: generalizable lessons from the NIH Collaboratory

Overview of attention for article published in BMC Medical Research Methodology, September 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (81st percentile)

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17 tweeters
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1 Facebook page

Citations

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26 Dimensions

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43 Mendeley
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Title
Pragmatic clinical trials embedded in healthcare systems: generalizable lessons from the NIH Collaboratory
Published in
BMC Medical Research Methodology, September 2017
DOI 10.1186/s12874-017-0420-7
Pubmed ID
Authors

Kevin P. Weinfurt, Adrian F. Hernandez, Gloria D. Coronado, Lynn L. DeBar, Laura M. Dember, Beverly B. Green, Patrick J. Heagerty, Susan S. Huang, Kathryn T. James, Jeffrey G. Jarvik, Eric B. Larson, Vincent Mor, Richard Platt, Gary E. Rosenthal, Edward J. Septimus, Gregory E. Simon, Karen L. Staman, Jeremy Sugarman, Miguel Vazquez, Douglas Zatzick, Lesley H. Curtis

Abstract

The clinical research enterprise is not producing the evidence decision makers arguably need in a timely and cost effective manner; research currently involves the use of labor-intensive parallel systems that are separate from clinical care. The emergence of pragmatic clinical trials (PCTs) poses a possible solution: these large-scale trials are embedded within routine clinical care and often involve cluster randomization of hospitals, clinics, primary care providers, etc. Interventions can be implemented by health system personnel through usual communication channels and quality improvement infrastructure, and data collected as part of routine clinical care. However, experience with these trials is nascent and best practices regarding design operational, analytic, and reporting methodologies are undeveloped. To strengthen the national capacity to implement cost-effective, large-scale PCTs, the Common Fund of the National Institutes of Health created the Health Care Systems Research Collaboratory (Collaboratory) to support the design, execution, and dissemination of a series of demonstration projects using a pragmatic research design. In this article, we will describe the Collaboratory, highlight some of the challenges encountered and solutions developed thus far, and discuss remaining barriers and opportunities for large-scale evidence generation using PCTs. A planning phase is critical, and even with careful planning, new challenges arise during execution; comparisons between arms can be complicated by unanticipated changes. Early and ongoing engagement with both health care system leaders and front-line clinicians is critical for success. There is also marked uncertainty when applying existing ethical and regulatory frameworks to PCTS, and using existing electronic health records for data capture adds complexity.

Twitter Demographics

The data shown below were collected from the profiles of 17 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 43 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 43 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 10 23%
Student > Ph. D. Student 8 19%
Unspecified 7 16%
Student > Master 4 9%
Other 4 9%
Other 10 23%
Readers by discipline Count As %
Medicine and Dentistry 14 33%
Unspecified 10 23%
Engineering 5 12%
Nursing and Health Professions 4 9%
Social Sciences 4 9%
Other 6 14%

Attention Score in Context

This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 October 2019.
All research outputs
#1,678,454
of 13,606,441 outputs
Outputs from BMC Medical Research Methodology
#279
of 1,254 outputs
Outputs of similar age
#50,102
of 270,437 outputs
Outputs of similar age from BMC Medical Research Methodology
#1
of 1 outputs
Altmetric has tracked 13,606,441 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,254 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.1. This one has done well, scoring higher than 77% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 270,437 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 81% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them