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The other notable titles include Wolf Gold and Chilli Heat.<br><br>The goal of pragmatic trials is to simulate real-life situations and achieve the highest level of validity externally. They are usually requested by practitioners and policymakers to guide their decisions. They are also a good method of determining the causality between an intervention and its outcomes. However, they should not be used as a substitute for explanation trials.<br><br>The pragmatism idea is controversial and there are doubts about whether pragmatic trials should replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which validate a physiological or clinical hypothesis as well as pragmatic trials, which guide the policy and practice of. They also proposed the framework for pragmatic trials, called PRECIS.2 This tool was designed to define the elements of a pragmatic trial that include the recruitment process, the design and implementation of the intervention, and monitoring.<br><br>There is a positive increase in the number of pragmatic trials that are published. A recent Medline search using the terms pragmatic and naturalistic, restricted to randomized controlled trials (RCTs) resulted in 34 articles, which are shown in red in Figure 2. This indicates that the health sciences community is becoming more sensitive to the issue of pragmatics. However, it is important to keep in mind that the majority of these trials were conducted in primary care settings.