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Pragmatic controlled clinical trials in primary care: the struggle between external and internal validity

Overview of attention for article published in BMC Medical Research Methodology, December 2003
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Mentioned by

news
6 news outlets
blogs
1 blog
twitter
6 X users

Citations

dimensions_citation
390 Dimensions

Readers on

mendeley
435 Mendeley
citeulike
2 CiteULike
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Title
Pragmatic controlled clinical trials in primary care: the struggle between external and internal validity
Published in
BMC Medical Research Methodology, December 2003
DOI 10.1186/1471-2288-3-28
Pubmed ID
Authors

Marshall Godwin, Lucia Ruhland, Ian Casson, Susan MacDonald, Dianne Delva, Richard Birtwhistle, Miu Lam, Rachelle Seguin

Abstract

Controlled clinical trials of health care interventions are either explanatory or pragmatic. Explanatory trials test whether an intervention is efficacious; that is, whether it can have a beneficial effect in an ideal situation. Pragmatic trials measure effectiveness; they measure the degree of beneficial effect in real clinical practice. In pragmatic trials, a balance between external validity (generalizability of the results) and internal validity (reliability or accuracy of the results) needs to be achieved. The explanatory trial seeks to maximize the internal validity by assuring rigorous control of all variables other than the intervention. The pragmatic trial seeks to maximize external validity to ensure that the results can be generalized. However the danger of pragmatic trials is that internal validity may be overly compromised in the effort to ensure generalizability. We are conducting two pragmatic randomized controlled trials on interventions in the management of hypertension in primary care. We describe the design of the trials and the steps taken to deal with the competing demands of external and internal validity.

X Demographics

X Demographics

The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 435 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 8 2%
United Kingdom 5 1%
Brazil 3 <1%
Netherlands 2 <1%
Spain 2 <1%
France 1 <1%
Austria 1 <1%
Tanzania, United Republic of 1 <1%
Colombia 1 <1%
Other 7 2%
Unknown 404 93%

Demographic breakdown

Readers by professional status Count As %
Student > Master 82 19%
Researcher 63 14%
Student > Ph. D. Student 63 14%
Student > Postgraduate 29 7%
Student > Bachelor 28 6%
Other 108 25%
Unknown 62 14%
Readers by discipline Count As %
Medicine and Dentistry 160 37%
Nursing and Health Professions 46 11%
Social Sciences 35 8%
Psychology 27 6%
Agricultural and Biological Sciences 21 5%
Other 64 15%
Unknown 82 19%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 57. 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 23 September 2023.
All research outputs
#732,567
of 25,008,338 outputs
Outputs from BMC Medical Research Methodology
#57
of 2,232 outputs
Outputs of similar age
#1,075
of 141,878 outputs
Outputs of similar age from BMC Medical Research Methodology
#1
of 5 outputs
Altmetric has tracked 25,008,338 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,232 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.4. This one has done particularly well, scoring higher than 97% 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 141,878 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 5 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