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Comment & Response
February 19, 2020

Pragmatic vs Explanatory Trials—Reply

Author Affiliations
  • 1Canadian VIGOUR Centre, University of Alberta, Edmonton, Alberta, Canada
  • 2Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
  • 3Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada
JAMA Cardiol. 2020;5(4):488. doi:10.1001/jamacardio.2019.6114

In Reply We thank Fernandes et al for their interest in our study1 and agree that this field requires further exploration. Explanatory trials are primed to maximize the likelihood of finding efficacy of an intervention by testing it in an ideal setting, whereas pragmatic trials aim to test effectiveness of an intervention in a more generalizable setting. Hence, they are expected to generate more generalizable results, with the risk understood that there may be more variation in less tightly controlled environments, which may result in differing results.

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