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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 a focus on the practical aspects of study design, including recruitment and consent, adherence and the use routinely available equipment.

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Another example of a pragmatic trial is the Home Blood Pressure Management (HBPM) study, which employed different investigators and participants from different geographical regions. This kind of heterogeneity is necessary for practical trials to be valid and also helps reduce bias in the results. However too much heterogeneity could cause problems with the design of the trial.

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The purpose of pragmatic trials is to mimic real-life scenarios and to achieve the highest level of validity externally. Usually, they are commissioned by policymakers and practitioners to help inform their decisions. They also provide a useful method of determining the causal relationship between the intervention and its effects. However, they should not, be used to replace the need for explanation studies.

The pragmatism idea is controversial, and there are concerns about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which validate the clinical or physiological hypothesis as well as pragmatic trials, which inform the policy and practice of. They also suggested a framework for pragmatic trials, 프라그마틱 플레이 called PRECIS.2 This tool was designed to define the characteristics of a pragmatic trial, including the recruitment process, the design and delivery of the intervention, and monitoring.

There is a growing increase in the number of pragmatic trials that are published. A recent Medline search using the words naturalistic and pragmatic, restricted to randomised controlled trials (RCTs) returned 34 articles. These are shown in red on Figure 2. This indicates that the health sciences community is becoming increasingly sensitized to the issue of pragmatics. It is important to note that the majority of studies were conducted in primary care settings.