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Trials designed to inform clinical practice in the real world are referred to as pragmatic trials. They are typically described as a focus on the practical aspects of design that include the recruitment and consent process, as well as adherence and the use of standard equipment.
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Another example of a pragmatic trial is the Home Blood Pressure Management (HBPM) study, which used various investigators and had participants from various geographical areas. This kind of heterogeneity is required for pragmatic trials to be able to prove their validity, and it also reduces bias in the results. A high degree of heterogeneity, however, can cause problems with the design of the trial.
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The purpose of pragmatic trials is to mimic real-life scenarios and gain maximum validity externally. They are usually commissioned by practitioners and policy makers to inform their decision making. They also provide a useful way to identify the cause-effect relationship between an intervention and its results. However, they shouldn't be used to substitute for the use of explanation trials.
The pragmatism idea is controversial and there are doubts about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which prove a physiological or clinical hypothesis as well as pragmatic trials, which guide policy and practice decisions. They also suggested a framework known as PRECIS for pragmatic trials.2 This tool attempted to define the elements of a pragmatic research study, including recruitment, design, delivery of the intervention and its follow-up.
The number of pragmatic trials is growing. A recent Medline search using the terms naturalistic and pragmatic, limited to randomized controlled trials (RCTs) resulted in 34 articles, as shown in red in Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatic thinking. 프라그마틱 슈가러쉬 is important to note, however, that the majority of these studies were conducted in primary care settings.