Appraising clinical applicability of studies: mapping and synthesis of current frameworks, and proposal of the FrACAS framework and VICORT checklist

BMC Medical Research Methodology

Mark R. Keezer¹  Eric Peters²  Erica M. Moodie³  Robert Goulden⁴  Christina Wolfson⁵  Sahar Saeed⁶  Marie-France Forget⁷  Philippe Desmarais⁸  Quoc Dinh Nguyen⁹ 

[1] Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Canada;Departments of Neurosciences & Social and Preventative Medicine, Université de Montréal, Montreal, Canada;Department of Anesthesia, Centre hospitalier universitaire Sainte-Justine, Montreal, Canada;Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada;Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada;Department of Medicine, McGill University, Montreal, Canada;Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada;Department of Medicine, McGill University, Montreal, Canada;Neuroepidemiology Research Unit, Research Institute of the McGill University Health Centre, Montreal, Canada;Department of Infectious Disease, Washington University in St. Louis, St. Louis, USA;Division of Geriatrics, Centre hospitalier de l’Université de Montréal, 1000, Saint-Denis, H2X0C1, Montreal, Quebec, Canada;Division of Geriatrics, Centre hospitalier de l’Université de Montréal, 1000, Saint-Denis, H2X0C1, Montreal, Quebec, Canada;Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Canada;Division of Geriatrics, Centre hospitalier de l’Université de Montréal, 1000, Saint-Denis, H2X0C1, Montreal, Quebec, Canada;Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Canada;Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada;

关键词: Quality assessment;    External validity;    Generalizability;    Impact;    Evidence-based practice;   

DOI  :  10.1186/s12874-021-01445-0

来源: Springer

【 摘 要 】

BackgroundNot all research findings are translated to clinical practice. Reasons for lack of applicability are varied, and multiple frameworks and criteria exist to appraise the general applicability of epidemiological and clinical research. In this two-part study, we identify, map, and synthesize frameworks and criteria; we develop a framework to assist clinicians to appraise applicability specifically from a clinical perspective.MethodsWe conducted a literature search in PubMed and Embase to identify frameworks appraising applicability of study results. Conceptual thematic analysis was used to synthesize frameworks and criteria. We carried out a framework development process integrating contemporary debates in epidemiology, findings from the literature search and synthesis, iterative pilot-testing, and brainstorming and consensus discussions to propose a concise framework to appraise clinical applicability.ResultsOf the 4622 references retrieved, we identified 26 unique frameworks featuring 21 criteria. Frameworks and criteria varied by scope and level of aggregation of the evidence appraised, target user, and specific area of applicability (internal validity, clinical applicability, external validity, and system applicability). Our proposed Framework Appraising the Clinical Applicability of Studies (FrACAS) classifies studies in three domains (research, practice informing, and practice changing) by examining six criteria sequentially: Validity, Indication-informativeness, Clinical relevance, Originality, Risk-benefit comprehensiveness, and Transposability (VICORT checklist).ConclusionsExisting frameworks to applicability vary by scope, target user, and area of applicability. We introduce FrACAS to specifically assess applicability from a clinical perspective. Our framework can be used as a tool for the design, appraisal, and interpretation of epidemiological and clinical studies.

【 授权许可】

CC BY