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Studies designed to provide insight into clinical practice in the real world are referred to as pragmatic trials. They are typically described as a focus on the practical aspects of study design, including recruitment and consent, adherence and the use of standard equipment.
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A pragmatic trial that uses various investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This type of heterogeneity which is vital for a pragmatic trial to be reliable and to reduce bias in the results is also essential. A high degree of heterogeneity, however could cause issues with the trial design.
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Legality
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Pragmatic trials seek to replicate real-world situations and have the highest external validity. They are usually requested by practitioners and policymakers to guide their decisions. They can also be a great method to determine the cause-effect relationship between the intervention and its effects. They should, however, not be used to replace explanatory studies.
The concept of pragmatism is controversial and there are concerns about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 suggested a distinction between explanatory trials, which confirm the validity of a clinical or physiological hypothesis as well as pragmatic trials, which inform policy and practice decisions. They also suggested a framework known as PRECIS for pragmatic trials.2 This tool tried to define the characteristics of a practical study which includes recruitment, design, implementation of the intervention and its follow-up.
There is a growing increase in the number of pragmatic trials that have been published. A recent Medline search using the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs), 프라그마틱 슬롯 팁 returned 34 articles. These are shown in red on Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatism. It is important to note, however, that the majority of studies were conducted in primary care settings.