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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 the recruitment process and consent, adhering and the use routinely available equipment.

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A practical trial that employs different investigators and participants from different geographical areas is the Home Blood Pressure Management study (HBPM). 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 too much heterogeneity could lead to problems with the design of the trial.

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Pragmatic trials aim to mimic real-world situations and have the highest external validity. They are usually requested by practitioners and policy makers to inform their decision making. They can also be a great method of determining the causality between the intervention and its effects. They should not, however, be used to replace the need for explanation studies.

The pragmatism idea is controversial and there are concerns about whether pragmatic trials can be used to replace explanation tests or if they should be a complement to them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which confirm the clinical or physiological hypothesis, 프라그마틱 슬롯 조작 and pragmatic trials, which inform policy and practice decisions. They also proposed an approach to pragmatic trials, dubbed PRECIS.2 This tool attempted to define the elements of a pragmatic trial that include the recruitment process, the design and implementation of the intervention, as well as monitoring.

There is a positive increase in the number of pragmatic trials published. A recent Medline search using the terms naturalistic and pragmatic, which was limited to randomized controlled trials (RCTs) resulted in 34 articles, as shown in red in Figure 2. This indicates that the health science community is becoming more acquaint to the subject of pragmatics. However, it is important to remember that the majority of these studies were conducted in primary care settings.