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Clinical trials that are designed to help inform practice in the real world are called pragmatic trials. They are often described as focusing on practical aspects of design, including 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 required for practical trials to be valid and helps to reduce bias in the results. However excessive heterogeneity could result in issues with the design of the trial.

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The purpose of pragmatic trials is to replicate real-life scenarios and to achieve maximum validity externally. Usually, they are commissioned by policymakers and practitioners to guide their decisions. They can also be used to determine the causal relationship between an intervention and its results. However, they shouldn't be used as a substitute for explanatory trials.

The concept of pragmatism is controversial, 프라그마틱 슬롯 조작 and there are doubts about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 proposed a distinction between explanatory studies, which support the physiological hypothesis or clinical hypothesis, as well as pragmatic trials, that inform the decision-making process for policy and practice. They also suggested a framework known as PRECIS for pragmatic trials.2 This tool tried to define the characteristics of a practical study, including recruitment, design, delivery of the intervention and its follow-up.

The number of pragmatic trials is increasing. A recent Medline query using the keywords pragmatic and naturalistic, which was restricted to randomised controlled trials (RCTs) returned 34 articles. These are shown in red on Figure 2. This is a sign that the health sciences community is becoming more acquaint to the subject of pragmatics. It is important to keep in mind, however, that the majority of studies were conducted in primary care settings.