Pragmatic trials and implementation science: grounds for divorce?
| Autor: | Ray Pawson |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Pragmatism
Generalisability Biomedical Research Epidemiology Debate media_common.quotation_subject Health Informatics Narrow shoulders 03 medical and health sciences 0302 clinical medicine Pragmatic Clinical Trials as Topic Humans 030212 general & internal medicine Sociology PRECIS models media_common Pragmatic trials Multi-methods lcsh:R5-920 Grounds for divorce 030503 health policy & services Heterogeneity of treatment effects Reproducibility of Results Pragmatic trial Research users Epistemology Intervention (law) Explication Research Design Evidence-Based Practice Close reading Within-case and cross-case analysis Implementation science lcsh:Medicine (General) 0305 other medical science Knowledge transfer |
| Zdroj: | BMC Medical Research Methodology BMC Medical Research Methodology, Vol 19, Iss 1, Pp 1-13 (2019) |
| ISSN: | 1471-2288 |
| Popis: | Background The paper opens with a brief history of two of the major intellectual components of the recent utilitarian turn in clinical research, namely ‘pragmatic trials’ and ‘implementation science’. The two schools of thought developed independently and the paper scrutinises their mutual compatibilities and incompatibilities, asking: i) what do the leading advocates of pragmatic trials assume about the transfer of research findings to real-world practice and ii) what role pragmatic trials can and should play in the evaluation of implementation science strategies. Methods The paper utilises ‘explication de texte’: i) providing a close reading of the inferential logics contained in major published expositions of the two paradigms, and ii) interrogating the conclusions of a pragmatic trial of an intervention providing guidelines on retinal screening aimed at family practitioners. Results The paper is in two parts. Part 1 unearths some significant incommensurability – the pragmatic trial literature retains an antiquated view of knowledge transfer and is overly optimistic about the wide applicability the findings of pragmatic trials to ‘real world’ conditions. Part 2 of the paper outlines an empirical strategy to better penetrate the mechanisms of knowledge transfer and to tackle the issue of the generalisabilty of research findings in implementation science. Conclusions Pragmatism, classically, is about problem solving and the melding of perspectives. The core research requirement in implementation science is a fundamental shift from the narrow shoulders of pragmatic trials to a model of explanation building based upon a multi-case, multi-method body of evidence. |
| Databáze: | OpenAIRE |
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