Rethinking Clinical Trials: A Living Textbook of Pragmatic Clinical Trials
Welcome to the Living Textbook of pragmatic clinical trials, a collection of knowledge from the NIH Pragmatic Trials Collaboratory. Pragmatic clinical trials present an opportunity to efficiently generate high-quality evidence to inform medical decision-making. However, these trials pose different challenges than traditional clinical trials. The Living Textbook reflects a collection of special considerations and best practices in the design, conduct, and reporting of pragmatic clinical trials. Watch the welcome video.
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What is the
NIH Pragmatic Trials Collaboratory?
What is a
pragmatic clinical trial?
Training Resources
Featured
Register for Full-Day Workshop on Dissemination and Implementation in ePCTs
On December 13, 2026, the NIH Pragmatic Trials Collaboratory will offer a full-day workshop as a part of the 19th Annual Conference on the Science of Dissemination and Implementation in Health. The workshop will provide an introduction to concepts in the design, conduct, dissemination, and implementation of pragmatic clinical trials embedded in healthcare systems, with a focus on methods relevant to health services researchers.
Recordings and Slides Available for Virtual Workshop on Endpoint Strategies and Meaningful Outcomes
On September 8 and 9, 2026, the NIH Pragmatic Trials Collaboratory hosted a free virtual workshop sharing best practices in thoughtfully selecting endpoints and interpreting treatment effects to inform decision-making. Access the materials.
NIH COLLABORATORY TRIALS
Pragmatic clinical trials that address questions of major public health importance and provide proof of concept for innovative pragmatic research designs.
CORES
Working groups that support the conduct of NIH Collaboratory Trials and generate guidance addressing implementation challenges.
DISTRIBUTED RESEARCH NETWORK
Network enabling investigators to collaborate in the use of electronic health data while safeguarding protected health information.
Upcoming Learning Opportunities
Grand Rounds November 6, 2026: Boosting Peri-Operative Pain Care: Mixed Results (and Myriad Implications) From the NOHARM Pragmatic Trial (Andrea Cheville, MD; Jon Tilburt, MD)
November 6 @ 1:00 pm - 2:00 pmGrand Rounds November 13, 2026: Physician Edits to AI-Drafted Patient Messages and Their Impact on Clinical Workload (Lily Poursoltan, MS, PhD)
November 13 @ 1:00 pm - 2:00 pmGrand Rounds November 20, 2026: Ranking or Weighting? Rethinking the Analytic Approach by Incorporating the Patient’s Voice in the Composite Endpoint (Huiman Barnhart, PhD; Shelby Reed, PhD)
November 20 @ 1:00 pm - 2:00 pm
NEWS
- November 4, 2026: Study Snapshots and Updated Ethics Documentation Available for LungSMART and STEP-2 TrialsNew study snapshots and updated ethics and regulatory documentation are now available for the LungSMART and STEP-2 trials. One year into the studies, and after receiving approval to transition to ...
- November 3, 2026: Main Outcomes From the NOHARM Trial, in This Week’s Rethinking Clinical Trials Grand RoundsIn this Friday’s Rethinking Clinical Trials Grand Rounds, Andrea Cheville and Jon Tilburt will present the main outcomes of the NOHARM trial, “Boosting Peri-Operative Pain Care: Mixed Results (and Myriad ...
- November 2, 2026: Study Design Paper Published for TAICHIKNEEThe study design paper for TAICHIKNEE has been published online in BMJ Open. Congratulations to the study team on reaching this important milestone for all NIH Collaboratory Trials! TAICHIKNEE is comparing ...