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Pragmatic trials are those that are designed to inform real-world clinical practice. They are often characterized by a focus on the practical aspects of the research design, like recruitment and consent as well as adherence to the use of routinely 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 which is vital for pragmatic trials to be reliable and reduce bias in results, is also necessary. However, too much heterogeneity can result in problems with the design of the trial.

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Pragmatic trials seek to replicate real-life situations and attain maximum external validity. They are typically ordered by policymakers and practitioners to help guide their decisions. They can be used to determine the causality of an intervention and its results. However, they should not be used to substitute for explanatory trials.

The pragmatism concept is controversial and there are concerns about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 made the distinction between explanation studies, which confirm the validity of a physiological or clinical hypothesis, and pragmatic trials, which inform the decision-making process for policy and practice. They also proposed an approach to pragmatic trials, called PRECIS.2 This tool attempted to define the elements of a pragmatic study which includes the recruitment process, the design and implementation of the intervention, and monitoring.

There is an encouraging trend in the number of pragmatic trials published. A recent Medline query using the keywords pragmatic and 프라그마틱 슬롯 추천 naturalistic, which was restricted to randomised controlled trials (RCTs), returned 34 articles. These are highlighted in red on Figure 2. This indicates that the health sciences community has become more aware of the importance of pragmatism. It is important to remember that the majority of these trials were conducted in primary care settings.