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Pragmatic trials are studies designed to inform real-world clinical practice. 프라그마틱 are often characterized by their focus on practical aspects of study design, including the recruitment process and consent, adhering and the use of routinely available equipment.
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A pragmatic trial that uses a variety investigators and includes participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This type of heterogeneity which is essential for a pragmatic trial to be valid and to reduce bias in the results, is also necessary. Too much heterogeneity, however can result in problems with the trial design.
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The purpose of pragmatic trials is to replicate real-life scenarios and gain maximum credibility externally. They are usually commissioned by policy makers and practitioners to inform their decision making. They can also be used to determine the causality of an intervention with its outcomes. They should not, however be used to replace explanatory studies.
The pragmatism idea is controversial, and there are doubts about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 proposed an distinction between explanation-based studies, which prove a physiological hypothesis or clinical hypothesis, and pragmatic trials, that inform the decision-making process for policy and practice. They also suggested the framework for pragmatic trials, called PRECIS.2 This tool sought to define the features of a practical trial which includes the recruitment process, the design and implementation of the intervention, as well as monitoring.
There is a positive trend in the number of pragmatic trials that are published. A recent Medline search using the terms naturalistic and pragmatic, limited to randomized controlled trials (RCTs), yielded 34 articles, as shown in red in Figure 2. This indicates that the health science community is becoming more sensitive to the subject of pragmatics. It is important to remember, however, that the majority of these studies were conducted in primary care settings.