Table 1 Readiness Assessment for Pragmatic Trials (RAPT) domains and scoring guidance
Domain | Assessment | Scoring Guidance | ||
|---|---|---|---|---|
Low | Medium | High | ||
1. Implementation protocola | Is the protocol sufficiently detailed to be replicated? | There is no protocol. | The protocol provides some documentation, but may be difficult to replicate. | The protocol is well documented and is likely to be replicable. |
2. Evidence | To what extent does the evidence base support the intervention’s efficacy? | There are no efficacy studies or the efficacy studies did not use rigorous methods (e.g., a RCT). | A single study using rigorous methods demonstrated efficacy. | Multiple studies using rigorous methods have demonstrated efficacy. |
3. Risk | Is it known how safe the intervention is? | The risks (harms and discomforts) are unknown or are known to be more than minimal (e.g., greater than ordinarily encountered in daily life). | The risks are unknown, but are likely minimal. | The risks are known to be minimal. |
4. Feasibility | To what extent can the intervention be implemented under existing conditions? | Resources necessary for implementation (e.g., staff, infrastructure, payment) are absent or insufficient. | Minor modifications to existing resources would enable implementation. | Implementation is possible with existing resources. |
5. Measurement | To what extent can the intervention’s outcomes be captured?a | Outcomes cannot be captured without major modifications to systems (e.g., clinical assessments, documentation, or electronic health records) or increases in staff time. | Outcomes can be captured with minor modifications to systems or increases in staff time. | Outcomes are already routinely captured. |
6. Cost | How likely is the intervention to be economically viable? | Cost-benefit/cost-effectiveness analysis has not been completed (formally or informally) and it is unknown whether benefits outweigh costs. | Cost-benefit/cost-effectiveness analysis has not been completed, but benefits are likely to outweigh costs. | Cost-benefit/cost-effectiveness analysis demonstrates benefits outweigh costs. |
7. Acceptability | How willing are providers likely to be to adopt the intervention? | Acceptability is unknown or staff are unlikely to believe the intervention is feasible or needed. | Acceptability is unknown, but staff are likely to believe the intervention is feasible or needed. | Acceptability is known and staff believe the intervention is feasible and needed. |
8. Alignment | To what extent does the intervention align with external stakeholders’ priorities? | Stakeholders (policymakers, payors, advocates, and others) do not believe the intervention addresses a current or anticipated priority. | Some stakeholders believe the intervention addresses a priority. | Most or all stakeholders believe the intervention addresses a priority. |
9. Impact | How useful will the intervention’s results be? | Providers and stakeholders (policymakers, payors, advocates, and others) are unlikely to believe that the outcomes are useful (e.g., to inform clinical care or policy). | Some providers or stakeholders are likely to believe the outcomes are useful. | Most or all providers and stakeholders are likely to believe the outcomes are useful. |