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Clinical trials that are designed to help inform practice in the real world are known as pragmatic trials. They are often described as a focus on the practical aspects of designing a study which include the recruitment process and consent, adhering and the use of routinely available equipment.

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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which employed different investigators and participants from various geographical areas. This type of heterogeneity is required for practical trials to be valid and helps to reduce bias in the results. However, too much heterogeneity could cause issues with the design of the trial.

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The aim of pragmatic trials is to mimic real-life scenarios and gain the highest level of validity externally. Usually, they are commissioned by policymakers and practitioners to guide their decisions. They are also a good method to determine the causal relationship between an intervention and its results. They should not, however, be used to replace the need for explanation studies.

The idea of pragmatism is controversial, 프라그마틱 이미지 [posteezy.com] and there are questions about whether pragmatic trials can replace tests for explanations or if they are an addition to them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which prove the validity of a clinical or physiological hypothesis as well as pragmatic trials that inform policy and practice decisions. They also suggested a framework dubbed PRECIS for pragmatic trials.2 This tool tried to define the elements of a pragmatic study which includes recruitment, design, delivery of the intervention and follow-up.

There is an encouraging increase in the number pragmatic trials that have been published. A recent Medline query that used the words naturalistic and pragmatic, restricted to randomised controlled trials (RCTs) returned 34 articles. These are highlighted in red on Figure 2. This is a sign that the health sciences community is becoming more sensitive to the issue of pragmatics. However, it is important to note that the majority of these trials were conducted in primary care settings.