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Pragmatic trials are studies designed to inform the practice of clinical trials in real life. They are usually characterized by a focus on the practical aspects of the research design, like recruitment and consent, adherence, and the use of commonly available equipment.
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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which used a variety of investigators and had participants from different geographic areas. This type of heterogeneity, which is essential for a pragmatic trial to be reliable and to reduce bias in the results, is also necessary. However excessive heterogeneity could lead to problems with the design of the trial.
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Pragmatic trials are designed to replicate real-life situations and attain maximum external validity. They are typically commissioned by policy makers and practitioners to inform their decision making. They also provide a useful way to identify the causality between an intervention and its outcomes. However, they shouldn't be used to substitute for explanation trials.
The idea of pragmatism is controversial and there are doubts about whether pragmatic trials can replace explanatory tests or if they are a complement to them. Schwartz and Lellouch1 made an distinction between explanation-based studies, which confirm the validity of a physiological or clinical hypothesis, as well as pragmatic trials, that inform the practice and policy decision-making. They also suggested a framework for pragmatic trials, 프라그마틱 무료 슬롯 which they called PRECIS.2 This tool attempted to define the elements of a practical trial that include the recruitment process, the design and implementation of the intervention, as well as follow-up.
The number of pragmatic trials is increasing. A recent Medline search using the keywords naturalistic and pragmatic, which was limited to controlled trials randomized to control (RCTs), yielded 34 articles, shown in red in Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatic thinking. However, it is important to note that the majority of these trials were conducted in primary care settings.
