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Open Access 01-12-2021 | Review

Understanding implementability in clinical trials: a pragmatic review and concept map

Authors: Miranda S. Cumpston, Steven A. Webb, Philippa Middleton, Greg Sharplin, Sally Green, for the Australian Clinical Trials Alliance Reference Group on Impact and Implementation of CTN Trials

Published in: Trials | Issue 1/2021

Abstract

Background

The translation of evidence from clinical trials into practice is complex. One approach to facilitating this translation is to consider the ‘implementability’ of trials as they are designed and conducted. Implementability of trials refers to characteristics of the design, execution and reporting of a late-phase clinical trial that can influence the capacity for the evidence generated by that trial to be implemented. On behalf of the Australian Clinical Trials Alliance (ACTA), the national peak body representing networks of clinician researchers conducting investigator-initiated clinical trials, we conducted a pragmatic literature review to develop a concept map of implementability.

Methods

Documents were included in the review if they related to the design, conduct and reporting of late-phase clinical trials; described factors that increased or decreased the capacity of trials to be implemented; and were published after 2009 in English. Eligible documents included systematic reviews, guidance documents, tools or primary studies (if other designs were not available). With an expert reference group, we developed a preliminary concept map and conducted a snowballing search based on known relevant papers and websites of key organisations in May 2019.

Results

Sixty-five resources were included. A final map of 38 concepts was developed covering the domains of validity, relevance and usability across the design, conduct and reporting of a trial. The concepts drew on literature relating to implementation science, consumer engagement, pragmatic trials, reporting, research waste and other fields. No single resource addressed more than ten of the 38 concepts in the map.

Conclusions

The concept map provides trialists with a tool to think through a range of areas in which practical action could enhance the implementability of their trials. Future work could validate the strength of the associations between the concepts identified and implementability of trials and investigate the effectiveness of steps to address each concept. ACTA will use this concept map to develop guidance for trialists in Australia.

Trial registration

This review did not include health-related outcomes and was therefore not eligible for registration in the PROSPERO register.

Available only for authorised users

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Title: Understanding implementability in clinical trials: a pragmatic review and concept map
Authors: Miranda S. Cumpston
Steven A. Webb
Philippa Middleton
Greg Sharplin
Sally Green
for the Australian Clinical Trials Alliance Reference Group on Impact and Implementation of CTN Trials
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: Trials / Issue 1/2021
Electronic ISSN: 1745-6215
DOI: https://doi.org/10.1186/s13063-021-05185-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Understanding implementability in clinical trials: a pragmatic review and concept map

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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