Pragmatic vs. explanatory: An adaptation of the PRECIS tool helps to judge the applicability of systematic reviews for daily practice

Tjarco Koppenaal, Joris Linmans, J. Andre Knottnerus, Mark Spigt*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

44 Citations (Web of Science)


Objective: The Pragmatic Explanatory Continuum Indicator Summary (PRECIS) tool was designed to classify randomized clinical trials (RCT) as being more pragmatic or explanatory. We modified the PRECIS tool (called PRECIS-Review tool [PR-tool]) to grade individual trials and systematic reviews of trials. This should help policy makers, clinicians, researchers, and guideline developers to judge the applicability of individual trials and systematic reviews. Study Design and Setting: To illustrate the usefulness and applicability of the PR-tool, we applied it to two systematic reviews. Each included RCT was scored on the 10 PRECIS domains on a scale of 1-5. After this scoring, a 10-domain average for each individual trial and for the systematic review a single domain average and an overall average was calculated. Results: One review was more pragmatic with an average score of 3.7 (range, 2.9-4.6) on our PR-tool, whereas the other review was more explanatory with an average score of 1.9 (range, 1.1-3.3). The results also suggest that the included studies within each systematic review were rather uniform in their approach, although some domains seemed more prone to heterogeneity. Conclusion: The PR-tool provides a useful estimate that gives insight by estimating quantitatively how pragmatic each RCT in the review is, which methodological domains are pragmatic or explanatory, and how pragmatic the review is.
Original languageEnglish
Pages (from-to)1095-1101
JournalJournal of Clinical Epidemiology
Issue number10
Publication statusPublished - Oct 2011


  • Systematic review
  • Randomized controlled trials
  • Pragmatic trial
  • Clinical trial methodology
  • Lifestyle intervention
  • Policy-making

Cite this