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Clinical trials that are designed to help inform practice in the real world are called pragmatic trials. They are often characterized as focusing on practical aspects of design that include recruitment and consent, adherence and the use of routinely available equipment.

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A pragmatic study that involves different investigators and participants from different geographical areas is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is necessary for practical trials to be valid, and it also helps to reduce bias in the results. However, too much heterogeneity can cause issues with the design of the trial.

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The goal of pragmatic trials is to mimic real-life scenarios and to achieve maximum credibility externally. They are usually commissioned by policymakers and practitioners to help inform their decisions. They can also be used to assess the cause-effect relationship of an intervention with its outcomes. They should not, however be used to replace the need for explanation studies.

The idea of pragmatism is controversial and there are doubts about whether pragmatic trials should replace explanatory tests or if they should serve as a complement to them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which confirm the clinical or physiological hypothesis and pragmatic trials, which inform policy and practice decisions. They also suggested a framework dubbed PRECIS for 프라그마틱 정품인증 pragmatic trials.2 This tool attempted to define the characteristics of a pragmatic study that includes recruitment, design, implementation of the intervention, and follow-up.

The number of pragmatic trials is increasing. A recent Medline search using the terms pragmatic and naturalistic, restricted to controlled trials that are randomized (RCTs), yielded 34 articles, as shown in red in Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to remember, however, that the majority of studies were conducted in primary-care settings.