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J Comp Eff Res. 2016 Aug;5(5):499-506. doi: 10.2217/cer-2016-0024. Epub 2016 Jul 15.

Physicians' perspectives regarding pragmatic clinical trials.

Author information

Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA.
Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
Division of General Internal Medicine, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Department of Health Policy & Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.



Practicing physicians inevitably become involved in pragmatic clinical trials (PCTs), including comparative effectiveness research. We sought to identify physicians' perspectives related to PCTs.


In-depth semistructured interviews with 20 physicians in the USA.


Although physicians are generally willing to participate in PCTs, their support is predicated on several factors including expected benefits, minimization of time and workflow burdens and physician engagement. Physicians communicated a desire to respect patients' rights and interests while maintaining a high level of care.


Future work is needed to systematically assess the impact of PCTs on clinicians in meeting their ethical obligations to patients and the burdens clinicians are willing to accept in exchange for potential benefits.


comparative effectiveness research; ethics; qualitative research

[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Financial & competing interests disclosure This work is supported by the National Institutes of Health (NIH) Common Fund, through a cooperative agreement (U54 AT007748) from the Office of Strategic Coordination within the Office of the NIH Director. J Sugarman serves on the Bioethics Advisory Panel and Stem Cell Research Oversight Committee for Merck KGaA. J Sugarman is also a member of the Ethics Advisory Panel for Quintiles and has been a consultant on bioethics for Novartis. M DeCamp served on a Bioethics Advisory Panel for Otsuka Pharmaceutical. None of these activities are directly related to the work described in this manuscript. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

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