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However, they shouldn't be used to substitute for explanation trials.<br><br>The pragmatism idea is controversial, and there are doubts about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 suggested a distinction between explanatory trials, which validate a physiological or clinical hypothesis as well as pragmatic trials, which inform the policy and practice of. They also suggested a framework known as PRECIS for pragmatic trials.2 This tool attempted to define the characteristics of a practical study, including recruitment, design, implementation of the intervention, and follow-up.<br><br>The number of pragmatic trials is growing. A recent Medline search using the terms naturalistic and pragmatic, which was limited to randomized controlled trials (RCTs) resulted in 34 articles, which are shown in red in Figure 2. This is a sign that the health sciences community is becoming increasingly sensitized to the subject of pragmatics. It is important to keep in mind that the majority of these studies were conducted in primary care settings.