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Related Experiment Videos

The "pragmatic trial": An essentially contested concept?

Ray Pawson1

  • 1School of Sociology and Social Policy, University of Leeds, Leeds, UK.

Journal of Evaluation in Clinical Practice
|July 18, 2019
PubMed
Summary

Clinical research faces a gap between treatment testing and application. This review examines pragmatic trials, designed to bridge this gap by mimicking real-world practice, to assess their clarity and impact.

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Area of Science:

  • Clinical Research Methodology
  • Translational Science

Background:

  • A persistent challenge in clinical research is the discrepancy between highly controlled treatment efficacy trials and real-world treatment application.
  • Real-world practice involves significant patient variability and implementation complexities not typically captured in efficacy studies.

Purpose of the Study:

  • To review the existing literature on pragmatic trials.
  • To evaluate whether the concept and execution of pragmatic trials have led to clarity or ongoing debate within clinical research methodology.

Main Methods:

  • Systematic review of the literature concerning pragmatic trials.
  • Analysis of studies focusing on the design, execution, and outcomes of pragmatic trials in various clinical settings.

Main Results:

Keywords:
PRECIS toolessentially contested conceptexplanatory trailpragmatic trial

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  • The concept of pragmatic trials aims to align clinical research with everyday medical practice.
  • Despite decades of discussion, the implementation and interpretation of pragmatic trials remain subjects of ongoing contestation.

Conclusions:

  • Pragmatic trials represent a proposed solution to bridge the efficacy-effectiveness gap in clinical research.
  • Further clarification and consensus are needed to fully realize the potential of pragmatic trials in informing clinical practice.