Applying the PRECIS criteria to describe three effectiveness trials of weight loss in obese patients with comorbid conditions

Abstract

Objectives: To characterize Practice-Based Opportunities for Weight Reduction (POWER) trials along the pragmatic-explanatory continuum.

Settings: The POWER trials consist of three individual studies that target obesity treatment in primary care settings.

Design: Using the PRagmatic Explanatory Continuum Indicator Summary (PRECIS) criteria, nine reviewers independently scored each trial.

Methods: Average and median ratings, inter-rater reliability, and relationships to additional ratings of the extent to which study designs were explanatory (i.e., efficacy) versus pragmatic (i.e., practical) and related to external validity were determined.

Principal findings: One trial was consistently rated as being significantly more pragmatic than the others (R(2) =0.43, p< .001), although all three were in the moderate range on the PRECIS scales. Ratings varied across PRECIS dimensions, being most pragmatic on comparison condition and primary outcome. Raters, although undergoing training and using identical definitions, scored their own study as more pragmatic than the other studies/interventions.

Conclusions: These results highlight the need for more comprehensive reporting on PRECIS and related criteria for research translation. The PRECIS criteria provide a richer understanding of the POWER studies. It is not clear whether the original criteria are sufficient to provide a comprehensive profile.

Figure 1

PRagmatic Explanatory Continuum Indicator Summary (PRECIS) “Spoke and Wheel” Diagrams: (a) Harvard School of Public Health Study; (b) University of Pennsylvania Study; (c) Johns Hopkins University Study