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Record W2034390498 · doi:10.2217/cer.12.37

Optimizing the design of pragmatic trials: key issues remain

2012· review· en· W2034390498 on OpenAlexaff
J. Jaime, K. Jack Ishak

Bibliographic record

VenueJournal of Comparative Effectiveness Research · 2012
Typereview
Languageen
FieldEconomics, Econometrics and Finance
TopicHealth Systems, Economic Evaluations, Quality of Life
Canadian institutionsMcGill University
Fundersnot available
KeywordsMedicineIntervention (counseling)Context (archaeology)Task (project management)Risk analysis (engineering)Clinical trialClinical study designManagement scienceResearch designNursing

Abstract

fetched live from OpenAlex

Clinical trials have largely focused on whether an intervention can work. To ensure valid and powerful testing of this hypothesis, trials attempt to maximize the effect of the intervention of interest, controlling other factors that can confound comparisons. The benefits observed in these studies are often not sustained once the treatment is used in routine care, leaving regulators, practitioners and patients with a paucity of reliable evidence to assist decision-making. Attempts to address this need have led to 'pragmatic trials' that prioritize applicability of findings to real-world practice by minimizing design features that produce less pertinent information. Minimizing biases in this pragmatic context remains a very difficult task, however. This paper reviews some of these challenges and highlights specific aspects of design that must be approached with a pragmatic attitude.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.640
metaresearch head score (Gemma)0.801
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesMetaresearch
DomainCandidate signal: Methods · Consensus signal: Methods
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: none
Teacher disagreement score0.360
Threshold uncertainty score0.444

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.6400.801
Meta-epidemiology (narrow)0.0040.004
Meta-epidemiology (broad)0.0140.005
Bibliometrics0.0050.006
Science and technology studies0.0030.018
Scholarly communication0.0120.023
Open science0.0080.007
Research integrity0.0160.019
Insufficient payload (model declined to judge)0.0050.003

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.907
GPT teacher head0.670
Teacher spread0.237 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; the direct Gemma label and the distilled Codex classifier agree on what is shown here.

Study designNot applicable
DomainMethods
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations10
Published2012
Admission routes1
Has abstractyes

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