Pragmatic Solomon Four-Group Design — Real-World Pretest Sensitization Control

The Pragmatic Solomon Four-Group Design combines the pretest-sensitization control logic of the classic Solomon (1949) four-group structure with the broad eligibility, flexible delivery, and real-world conditions characteristic of pragmatic trials. Four groups are formed: two receive the intervention (one pretested, one not) and two serve as controls (one pretested, one not), allowing simultaneous estimation of treatment effects and pretest sensitization effects under ecologically valid settings.