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Pragmatic trials are those that are designed to provide information for the real-world practice of clinical. They are often characterized by a focus on practical aspects of the research design, like recruitment and consent, adherence, and the use of standard equipment.

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A pragmatic study that involves different investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is essential for practical trials to be valid and helps to reduce the chance of bias in the results. A high degree of heterogeneity, however, can cause problems with the trial design.

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The aim of pragmatic trials is to replicate real-life scenarios and gain maximum credibility externally. They are typically commissioned by policymakers and practitioners to inform their decisions. They can also be used to assess the causal relationship between an intervention and its results. They should not, however be used to replace explanation studies.

The idea of pragmatism is controversial, and there are questions about whether pragmatic trials can replace explanatory tests or if they should serve as a complement to them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which prove a physiological or clinical hypothesis and pragmatic trials, which inform the policy and practice of. They also proposed a framework called PRECIS for pragmatic trials.2 The tool was designed to define the characteristics of a pragmatic research study, including the recruitment, design, and delivery of the intervention and follow-up.

There is an encouraging increase in the number of pragmatic trials that are published. A recent Medline search using the words naturalistic and pragmatic, restricted to randomised controlled trials (RCTs) returned 34 articles. These are highlighted in red on Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to keep in mind that the majority of these trials were conducted in primary care settings.