Explaining pragmatic trials to pragmatic policy-makers
Author(s)/Editor(s): Maclure M
Publisher/Organizer: CMAJ
Publication date: May 12, 2009; 180 (10)
Language: English
Overview
“Successful policy-makers value pragmatism. As politics is "the art of the possible," pragmatism is the art of the practical and workable. It entails getting more results sooner through flexibility rather than slavish adherence to rigid preconceptions. This requires experience with the trade-offs between quality and timeliness, between central control and local adaptation, and between leading and following. It calls for good judgment on when to uphold principles versus when to compromise, such as when to abide by experts’ systematic reviews of evidence versus heeding opinion-based consensus.
The term "pragmatic randomized trials," therefore, is intrinsically attractive to policy-makers. Juxtaposed with "pragmatic," the term "explanatory" suggests something more advisory. In the culture of policy-making, the juxtaposition is reminiscent of the 2 major types of briefing notes: "for decision" and "for information." The first serves decision-making on specific actions such as funding, regulations and organizational changes. The second serves communication of news, history, context, long-term options and strategic directions. ”