In Reply Drs Saugel and Reuter challenge the description of the OPTIMISE trial as a pragmatic trial. As applied to clinical trials, the term pragmatic has a particular meaning. Pragmatic trials are designed to evaluate the clinical effectiveness of a treatment in the context of routine clinical practice.1 This distinguishes them from explanatory trials, which are designed to evaluate the efficacy of a treatment under ideal conditions.
Pearse RM, MacDonald N, Grocott MPW, for the OPTIMISE Study Group. Use of Hemodynamic Algorithm After Gastrointestinal Surgery—Reply. JAMA. 2014;312(14):1471. doi:10.1001/jama.2014.10366