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© 1989 Oxford University Press

research-article

Pragmatic and Explanatory Trials in the Evaluation of the Experimental National Health Service Nursing Homes

JOHN BOND, ANN ATKINSON, BARBARA A. GREGSON and DAVID J. NEWELL

Health Care Research Unit, 21 Claremont Place, The University Newcastle upon Tyne NE2 4AA*
Policy Services Unit, Newcastle City Council, Civic Centre Newcastle upon Tyne NE1 8QN
Emeritus Professor of Medical Statistics, University of Newcastle upon Tyne

*Address for correspondence

This paper reviews the issues which arose in the design of a randomized controlled trial of three experimental National Health Service nursing homes. Problems associated with the implementation of the trial included ethical issues, choice of sample size and recruitment of subjects to the trial, choice and validity of measures of outcome, evaluation of outcomes and replicability of findings. The distinction between explanatory and pragmatic trials is shown to overcome some of these problems.

accepted in revised form September 17, 1988.


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