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Pragmatic trials are those that are designed to inform real-world clinical practice. They are often focused on practical aspects of the study design, including the recruitment and consent process as well as adherence to the use of commonly available equipment.
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A pragmatic study that involves various investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This type of heterogeneity is essential for pragmatic trials to be able to prove their validity and reduces bias in the results. However too much heterogeneity could cause issues with the design of the trial.
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The aim of pragmatic trials is to replicate real-life scenarios and to achieve maximum credibility externally. They are typically ordered by policymakers and practitioners to inform their decisions. They also provide a useful method to determine the causality between an intervention and its outcomes. However, they should not be used to substitute for the use of explanation studies.
The pragmatism idea 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 validate the clinical or physiological hypothesis as well as pragmatic trials, which inform the practice and policy decisions. They also proposed a framework for 슬롯 (Https://sitesrow.com/) pragmatic trials, dubbed PRECIS.2 This tool sought to define the characteristics of a pragmatic study which includes the recruitment process, the design and delivery of the intervention, and the follow-up.
There is a growing trend in the number of pragmatic trials published. A recent Medline search using the terms pragmatic and naturalistic, restricted to controlled trials that are randomized (RCTs), yielded 34 articles, which are shown in red in Figure 2. This indicates that the health sciences community is becoming increasingly sensitized to the subject of pragmatic thinking. However, it is important to keep in mind that the majority of these studies were conducted in primary care settings.(Image: https://pragmatickr.com/wp-content/uploads/2024/05/B6EC9C8BEB90-8BEDB0.png)
