Practical, practice, and policy relevant trials

There is a well-documented gap between research and practice in diabetes and many other chronic illnesses. This gap is due, in part, to limitations of the research database. Different types of clinical trials have recently been called for that address issues central to clinicians, administrative decision makers, and policy makers. Such "practical clinical trials" that are conducted in multiple heterogeneous settings offer great potential. They include diverse patient populations, study clinically relevant and feasible interventions, and assess multiple outcomes. In this article, examples of these trials are provided, and design features that will facilitate clinical and policy decision making are summarized.