Explaining pragmatic trials to pragmatic policymakers.

摘要

Successful policymakers 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 vs. when to compromise, such as when to abide by experts' systematic reviews of evidence vs. heeding opinion-based consensus. The term "pragmatic randomized trials" therefore is Xin-trinsically attractive to policymakers. Juxtaposed with "pragmatic", the term "explanatory" suggests something more advisory. In the culture of policymaking, the juxtaposition is reminiscent of the two major types of briefing notes-"For Decision" and "For Information." The first serves decision-making on specific actions, such as funding, regulations, or organization changes. The second serves communication of news, history, context, long-term options, or strategic directions.