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Trials designed to inform clinical practice in the real world are known as pragmatic trials. They are typically described as focusing on practical aspects of study design, including the recruitment and consent process, as well as 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 used a variety of investigators and participants from different geographic areas. This kind of heterogeneity is essential for pragmatic trials to be valid and helps to reduce the chance of bias in the results. Too much heterogeneity, however could cause issues with the trial design.

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The aim of pragmatic trials is to mimic real-life scenarios and gain the highest level of validity externally. They are typically commissioned by practitioners and policy makers to aid in their decision-making. They are also a good way to identify the cause-effect relationship between an intervention and its outcomes. They should, however, not, be used to replace the need for explanation studies.

The pragmatism concept is controversial and there are questions about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 made a distinction between explanatory studies, which support the physiological hypothesis or clinical hypothesis, as well as pragmatic trials, 프라그마틱 추천 which inform the decision-making process for policy and practice. They also proposed a framework called PRECIS for pragmatic trials.2 The tool was designed to define the characteristics of a practical study which includes recruitment, design, implementation of the intervention, and follow-up.

The number of pragmatic trials is growing. A recent Medline search using the keywords pragmatic and naturalistic, restricted to controlled trials randomized to control (RCTs), yielded 34 articles, as shown in red in Figure 2. This indicates that the health sciences community is becoming more acquaint to the subject of pragmatism. It is important to keep in mind that the majority of these studies were conducted in primary-care settings.