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Trials designed to inform clinical practice in the real world are called pragmatic trials. They are typically described as focusing on practical aspects of study design which include recruitment and consent, adherence and the use routinely available equipment.

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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which used various investigators and had participants from different geographical regions. This type of heterogeneity which is essential for a pragmatic trial to be valid and lessen the chance of bias, is also necessary. A high degree of heterogeneity, however, can cause problems with the trial design.

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Pragmatic trials are designed to replicate real-life settings and achieve maximum external validity. They are typically ordered by policymakers and practitioners to help guide their decisions. They can be used to determine the causality of an intervention and its effects. However, they shouldn't be used to substitute for explanatory trials.

The idea of pragmatism is controversial and there are doubts about whether pragmatic trials can be used to replace explanation tests or if they are a complement to them. Schwartz and Lellouch1 made an distinction between explanation-based studies, which confirm a physiological hypothesis or clinical hypothesis, and pragmatic trials, that inform the decision-making process for policy and practice. They also proposed the framework for pragmatic trials, which they called PRECIS.2 This tool was designed to define the characteristics of a pragmatic trial which includes the recruitment process, 프라그마틱 정품인증 the design and implementation of the intervention, as well as monitoring.

The number of pragmatic trials is growing. A recent Medline search using the keywords pragmatic and naturalistic, restricted to controlled trials randomized to control (RCTs) resulted in 34 articles, which are shown in red in Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatism. However, it is important to remember that the majority of these studies were conducted in primary care settings.