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Clinical trials that are designed to help inform practice in the real world are called pragmatic trials. They are typically characterized by a focus on practical aspects of the study design, such as recruitment and consent, adherence, and the use of commonly available equipment.

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Another example of a pragmatic trial is the Home Blood Pressure Management (HBPM) study, which used various investigators and included participants from different geographical regions. This kind of heterogeneity is essential for practical trials to be valid and also helps to reduce bias in the results. A high degree of heterogeneity, however, can cause problems with the trial design.

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Pragmatic trials are designed to replicate real-life settings and achieve maximum external validity. They are usually requested by practitioners and policymakers to help inform their decisions. They can also be a great way to identify the cause-effect relationship between the intervention and its effects. However, they shouldn't be used as a substitute for explanatory trials.

The idea of pragmatism is controversial, and there are questions about whether pragmatic trials can replace explanatory tests or if they are an addition to them. Schwartz and Lellouch1 suggested the distinction between explanation 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 an approach to pragmatic trials, dubbed PRECIS.2 This tool was designed to define the elements of a pragmatic trial which includes recruitment, design and delivery of the intervention, and the follow-up.

There is a positive increase in the number pragmatic trials that have been published. A recent Medline query using the keywords pragmatic and naturalistic, 프라그마틱 무료체험 which was restricted to randomised controlled trials (RCTs) returned 34 articles. These are highlighted in red on Figure 2. This is an indication that the health sciences community is becoming more sensitive to the subject of pragmatics. However, it is important to remember that the majority of these studies were conducted in primary care settings.