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Schwartz and Lellouch1 made the distinction between explanation studies, which confirm the validity of a physiological or clinical hypothesis, as well as pragmatic trials, which inform policy and practice decision-making. They also proposed a framework called PRECIS for pragmatic trials.2 This tool tried to define the characteristics of a pragmatic study that includes recruitment, design, delivery of the intervention, and follow-up.<br><br>The number of pragmatic trials is increasing. A recent Medline query that used the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs) returned 34 articles. They are displayed in red on Figure 2. This indicates that the health science community is becoming more acquaint to the subject of pragmatism. However, it is important to note that the majority of these trials were conducted in primary care settings.