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Trials designed to inform clinical practice in the real world are called pragmatic trials. They are typically described as focusing on practical aspects of study design that include recruitment and consent,
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A pragmatic study that involves different investigators and participants from different geographical areas is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is necessary for pragmatic trials to be valid, and it also helps reduce the chance of bias in the results. However, too much heterogeneity can lead to problems with the design of the trial.
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Pragmatic trials are designed to replicate real-world situations and have the highest external validity. They are usually commissioned by policymakers and practitioners to help inform their decisions. They can also be used to determine the causality of an intervention and its effects. However, they shouldn't be used as a substitute for explanatory studies.
The pragmatism idea 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 support a physiological hypothesis or clinical hypothesis, and pragmatic trials, that inform policy and practice decision-making. They also suggested an approach to pragmatic trials, dubbed PRECIS.2 This tool attempted to define the characteristics of a pragmatic study that include the recruitment process, the design and
프라그마틱 체험 implementation of the intervention, as well as follow-up.
The number of pragmatic trials is increasing. A recent Medline search using the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs) returned 34 articles. They are displayed in red on Figure 2. This is a sign that the health sciences community is becoming more sensitive to the issue of pragmatics. It is important to keep in mind, however, that the majority of these studies were conducted in primary care settings.