Sep 25, 2003

Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy

JAMA : the Journal of the American Medical Association
Sean R TunisCarolyn M Clancy

Abstract

Decision makers in health care are increasingly interested in using high-quality scientific evidence to support clinical and health policy choices; however, the quality of available scientific evidence is often found to be inadequate. Reliable evidence is essential to improve health care quality and to support efficient use of limited resources. The widespread gaps in evidence-based knowledge suggest that systematic flaws exist in the production of scientific evidence, in part because there is no consistent effort to conduct clinical trials designed to meet the needs of decision makers. Clinical trials for which the hypothesis and study design are developed specifically to answer the questions faced by decision makers are called pragmatic or practical clinical trials (PCTs). The characteristic features of PCTs are that they (1) select clinically relevant alternative interventions to compare, (2) include a diverse population of study participants, (3) recruit participants from heterogeneous practice settings, and (4) collect data on a broad range of health outcomes. The supply of PCTs is limited primarily because the major funders of clinical research, the National Institutes of Health and the medical products industry, do not f...Continue Reading

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Mentioned in this Paper

Endoscopy (Procedure)
National Health Policy
Morbidity Aspects
Antibiotic throat preparations
Helicobacter pylori
Aneurysm
Antifungal Antibiotics, Topical
Cost Effectiveness
Health Outcomes
Myocardium

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