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Trials designed to inform clinical practice in the real world are called pragmatic trials. They are often characterized as a focus on the practical aspects of design, including the recruitment and consent process, as well as adherence and the use of routinely available equipment.

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A pragmatic trial that uses different investigators and participants from various geographical regions is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity, which is vital for a pragmatic trial to be reliable and reduce bias in results is also essential. However, too much heterogeneity can result in problems with the design of the trial.

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The aim of pragmatic trials is to replicate real-life situations and achieve maximum credibility externally. Usually, they are ordered by policymakers and practitioners to inform their decisions. They can also be a great method to determine the causality between the intervention and its effects. They should not, however be used to replace explanatory studies.

The idea of pragmatism is controversial and there are concerns regarding whether pragmatic trials could be used to replace explanation tests or if they should serve as an alternative to them. Schwartz and Lellouch1 made an distinction between explanation-based studies, which prove the physiological hypothesis or clinical hypothesis, as well as pragmatic trials, that inform policy and practice decision-making. They also proposed a framework called PRECIS for pragmatic trials.2 The tool was designed to define the traits of a pragmatic study, 프라그마틱 플레이 including the recruitment, design, and delivery of the intervention and its follow-up.

The number of pragmatic trials is growing. A recent Medline search using the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs) returned 34 articles. They are displayed in red on Figure 2. This is a sign that the health science community is becoming more sensitive to the issue of pragmatism. It is important to keep in mind that the majority of these trials were conducted in primary care settings.