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Pragmatic Randomized Controlled Trial — Real-World Experimental Evidence

A pragmatic randomized controlled trial (pRCT) tests whether an intervention works under ordinary, real-world conditions — broad eligibility, flexible delivery, and routine care settings. Participants are still randomly assigned to treatment or control, preserving causal inference, but the study is designed to reflect the diversity and variability of actual practice rather than the ideal conditions of an explanatory trial. The defining framework is the PRECIS-2 tool, which maps any RCT along nine pragmatic-to-explanatory dimensions.

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Sources

  1. Schwartz, D., & Lellouch, J. (1967). Explanatory and pragmatic attitudes in therapeutical trials. Journal of Chronic Diseases, 20(8), 637–648. DOI: 10.1016/0021-9681(67)90041-0
  2. Thorpe, K. E., Zwarenstein, M., Oxman, A. D., Treweek, S., Furberg, C. D., Altman, D. G., … Chalkidou, K. (2009). A pragmatic–explanatory continuum indicator summary (PRECIS): a tool to help trial designers. Journal of Clinical Epidemiology, 62(5), 464–475. DOI: 10.1016/j.jclinepi.2008.12.011

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ScholarGatePragmatic Randomized Controlled Trial (Pragmatic Randomized Controlled Trial). Retrieved 2026-06-04 from https://scholargate.app/en/experimental-design/pragmatic-randomized-controlled-trial