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Studies designed to provide insight into clinical practice in the real world are referred to as pragmatic trials. They are often focused on the practical aspects of study design, such as the recruitment and consent process, adherence, and the use of commonly available equipment.
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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which used a variety of investigators and included participants from various geographical areas. This type of heterogeneity is essential for practical trials to be valid, and it also helps reduce bias in the results. However excessive heterogeneity could lead to issues with the design of the trial.
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The aim of pragmatic trials is to simulate real-life scenarios and to achieve maximum validity externally. They are usually commissioned by practitioners and policy makers to guide their decision-making. They are also a good method to determine the cause-effect relationship between an intervention and its results. They should, however, not, be used to replace the need for explanation studies.
The concept of pragmatism is controversial and there are doubts about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 made a distinction between explanatory studies, which support a physiological hypothesis or clinical hypothesis, and pragmatic trials that aid in the practice and policy decision-making. They also suggested the framework for pragmatic trials, called PRECIS.2 This tool attempted to define the features of a practical trial which includes the recruitment process, the design and delivery of the intervention, as well as monitoring.
There is an encouraging trend in the number of pragmatic trials that have been published. A recent Medline search using the keywords pragmatic and naturalistic, 프라그마틱 슬롯 체험 (Socialdosa.Com) restricted to randomized controlled trials (RCTs) resulted in 34 articles, as shown in red in Figure 2. This is a sign that the health sciences community is becoming more acquaint to the subject of pragmatics. However, it is important to note that the majority of these trials were conducted in primary care settings.