ALT FDA logo top right. What is a pragmatic clinical trial? A clinical trial designed to efficiently inform decision-making on the benefits, burdens and risks of health interventions in representative populations by including pragmatic elements that 1) are partially or fully integrated into routine clinical practice or 2) that streamline trial design and conduct. Pragmatic elements - Design features that can be integrated into a clinical trial including but not limited one or more of the following elements: broad eligibility criteria, simplified recruitment and follow-up, flexibility in delivery of the intervention (e.g., community settings), flexibility in assessment frequency, measurement of outcomes relevant to the population.