• Kirsty Loudon, Merrick Zwarenstein, Frank M Sullivan, Peter T Donnan, Ildikó Gágyor, Hans J S M Hobbelen, Fernando Althabe, Jerry A Krishnan, and Shaun Treweek.
• Nursing Midwifery and Allied Health Professions Research Unit, Unit 13 Scion House, University of Stirling Innovation Park, Stirling FK9 4NF, UK. Electronic address: kirsty.loudon@stir.ac.uk.
• J Clin Epidemiol. 2017 Aug 1; 88: 113-121.

ObjectivesPRagmatic Explanatory Continuum Indicator Summary (PRECIS)-2 is a tool that could improve design insight for trialists. Our aim was to validate the PRECIS-2 tool, unlike its predecessor, testing the discriminant validity and interrater reliability.Study Design And SettingOver 80 international trialists, methodologists, clinicians, and policymakers created PRECIS-2 helping to ensure face validity and content validity. The interrater reliability of PRECIS-2 was measured using 19 experienced trialists who used PRECIS-2 to score a diverse sample of 15 randomized controlled trial protocols. Discriminant validity was tested with two raters to independently determine if the trial protocols were more pragmatic or more explanatory, with scores from the 19 raters for the 15 trials as predictors of pragmatism.ResultsInterrater reliability was generally good, with seven of nine domains having an intraclass correlation coefficient over 0.65. Flexibility (adherence) and recruitment had wide confidence intervals, but raters found these difficult to rate and wanted more information. Each of the nine PRECIS-2 domains could be used to differentiate between trials taking more pragmatic or more explanatory approaches with better than chance discrimination for all domains.ConclusionWe have assessed the validity and reliability of PRECIS-2. An elaboration study and web site provide guidance to help future users of the tool which is continuing to be tested by trial teams, systematic reviewers, and funders.Copyright © 2017 Elsevier Inc. All rights reserved.

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