Evidence-appraisal glossary
Pragmatic trial
A randomized trial designed to measure how well a treatment works in everyday clinical practice, using broad eligibility, routine settings, and usual care as the comparison. It aims to inform real decisions rather than isolate a mechanism.
Also called: pragmatic clinical trial, effectiveness trial.
Pragmatic trials enroll the kind of varied patients clinicians actually see and let care proceed close to normal, so their results speak to effectiveness under real conditions. They sit at the opposite end of a spectrum from explanatory trials, which tightly control conditions to measure efficacy. The trade-off is looser control: flexible protocols and mixed adherence can blur exactly why a treatment did or did not help, so a pragmatic result answers whether it works in practice more than how.
This is a plain-language methodology definition for reading research. It is general education, not medical advice.