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Pragmatic trials are those that are designed to provide information for real-world clinical practice. They are often characterized by their focus on practical aspects of designing a study which include recruitment and consent, adherence and the use of standard equipment.

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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which employed various investigators and included participants from different geographical regions. This kind of heterogeneity is essential for pragmatic trials to be able to prove their validity and also helps to reduce the chance of bias in the results. However excessive heterogeneity could lead to problems with the design of the trial.

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The goal of pragmatic trials is to simulate real-life scenarios and gain the highest level of validity externally. They are typically commissioned by practitioners and policy makers to guide their decision-making. They can be used to determine the causality of an intervention with its outcomes. However, they shouldn't be used to substitute for the use of explanation trials.

The idea of pragmatism is controversial and there are doubts regarding whether pragmatic trials could replace explanatory tests or if they should serve as an alternative to them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which validate the clinical or physiological hypothesis, and pragmatic trials, which inform the practice and policy decisions. They also suggested a framework known as PRECIS for pragmatic trials.2 The tool was designed to define the traits of a pragmatic research study that includes the recruitment, design, and delivery of the intervention and its follow-up.

There is a positive increase in the number of pragmatic trials that are published. A recent Medline query that used the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs), 프라그마틱 데모 returned 34 articles. These are highlighted in red on Figure 2. This is a sign that the health sciences community is becoming more sensitive to the issue of pragmatism. It is important to keep in mind that the majority of these studies were conducted in primary-care settings.