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The pragmatism idea is controversial, and there are questions about whether pragmatic trials should replace explanatory tests or if they should be an alternative to them. Schwartz and Lellouch1 proposed a distinction between explanatory studies, which support the physiological hypothesis or clinical hypothesis, and pragmatic trials, which inform the decision-making process for policy and practice. They also suggested an approach to pragmatic trials, which they called PRECIS.2 This tool was designed to define the characteristics of a practical trial which includes the recruitment process, the design and implementation of the intervention, as well as the follow-up. There is a positive increase in the number of pragmatic trials that have been published. A recent Medline search using the words pragmatic and naturalistic, which was restricted to randomised controlled trials (RCTs), returned 34 articles. These are highlighted in red on Figure 2. https://freeman-pridgen.federatedjournals.com/the-12-best-pragmatic-slots-accounts-to-follow-on-twitter indicates that the health sciences community has become more aware of the importance of pragmatism. It is important to keep in mind that the majority of these trials were conducted in primary care settings.