Abstract
BackgroundThe 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.MethodsDocuments 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.ResultsSixty-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.ConclusionsThe 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 registrationThis review did not include health-related outcomes and was therefore not eligible for registration in the PROSPERO register.
Highlights
The translation of evidence from clinical trials into practice is complex
Drawing on a range of guidance documents, empirical studies of trial design and factors influencing implementation, and practical tools for trialists, our findings indicate that while some of these concepts are well covered in the literature, no previous work has drawn together these concepts and mapped the construct of implementability for trials in this overarching way
This study presents a detailed map identifying 38 concepts that can enhance the implementability of clinical trials—that is, their capacity to be implemented in policy or practice, should their findings be appropriate for implementation
Summary
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 investigatorinitiated clinical trials, we conducted a pragmatic literature review to develop a concept map of implementability. We focus on the concept of implementability of a trial’s findings. We define implementability as the characteristics of the design, execution and reporting of a clinical trial, typically a late-phase trial, that influence the capacity for the evidence generated by that trial to be implemented. The characteristics that mean the findings of a trial could be implemented, should that be appropriate
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