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프라그마틱 데모 that are designed to help inform practice in the real world are called pragmatic trials. They are often described as a focus on the practical aspects of designing a study which include recruitment and consent, adherence and the use of routinely available equipment.
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Another example of a pragmatic trial is the Home Blood Pressure Management (HBPM) study, which used a variety of investigators and had participants from different geographic areas. This type of heterogeneity which is vital for pragmatic trials to be reliable and to reduce bias in the results is also essential. A high degree of heterogeneity, however can result in problems with the trial design.
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The purpose of pragmatic trials is to simulate real-life situations and achieve maximum validity externally. Usually, they are commissioned by policymakers and practitioners in order to inform their decisions. They can also be used to assess the causal relationship between an intervention and its effects. However, they should not be used to substitute for the use of explanation studies.
The pragmatism concept is controversial, and there are concerns about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which confirm the validity of a clinical or physiological hypothesis and pragmatic trials, which 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 pragmatic research study which includes recruitment, design, delivery of the intervention and its follow-up.
There is a growing increase in the number pragmatic trials that have been published. A recent Medline query using the keywords naturalistic and pragmatic, restricted to randomised controlled trials (RCTs) returned 34 articles. They are displayed in red on Figure 2. This is an indication that the health science community is becoming more acquaint to the issue of pragmatic thinking. It is important to keep in mind that the majority of these studies were conducted in primary care settings.