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Schwartz and Lellouch1 suggested the distinction between explanatory trials, which confirm the validity of a clinical or physiological hypothesis as well as pragmatic trials that inform the practice and policy decisions. They also suggested the framework for pragmatic trials, called PRECIS.2 This tool attempted to define the elements of a practical trial that include the recruitment process, the design and implementation of the intervention, and the follow-up.<br><br>There is an encouraging trend in the number of pragmatic trials published. A recent Medline query that used the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs) returned 34 articles. These are highlighted in red on Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatism. It is important to note that the majority of these trials were conducted in primary care settings.