Pragmatic Adaptive Experiment — Real-World Adaptive Trial Design

A pragmatic adaptive experiment is a hybrid clinical trial design that combines the real-world generalizability of pragmatic trials with the statistical flexibility of adaptive designs. It enrolls a broad, representative patient population under routine care conditions, while using pre-specified interim analyses to modify trial parameters — such as sample size, allocation ratios, or arm selection — as outcome data accumulate. The result is a design that is both externally valid and resource-efficient.