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Clinical trials that are designed to help inform practice in the real world are known as pragmatic trials. They are often characterized as a focus on the practical aspects of designing a study which include the recruitment process and consent, adhering and the use of standard equipment.

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A pragmatic study that involves a variety investigators and includes participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This type of heterogeneity is essential for practical trials to be valid, and it also helps to reduce the chance of bias in the results. Too much heterogeneity, however, can cause problems with the trial design.

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The goal of pragmatic trials is to simulate real-life scenarios and to achieve maximum validity externally. They are typically requested by practitioners and policymakers in order to inform their decisions. They also provide a useful way to identify the cause-effect relationship between an intervention and its outcomes. However, they shouldn't be used in lieu for the use of explanation trials.

The pragmatism idea is controversial and there are doubts about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 suggested a distinction between explanatory trials, which prove the validity of a clinical or physiological hypothesis and pragmatic trials that inform the policy and practice of. They also suggested a framework known as PRECIS for pragmatic trials.2 The tool was designed to define the characteristics of a practical study, including recruitment, design, implementation of the intervention and follow-up.

There is a positive increase in the number of pragmatic trials that have been published. A recent Medline search using the keywords naturalistic and pragmatic, limited to controlled trials randomized to control (RCTs), yielded 34 articles, as shown in red in Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to note, however, that the majority of studies were conducted in primary-care settings.