BACKGROUND The paper opens with a brief history of two of the major intellectual components of the recent utilitarian turn in clinical research, namely 'pragmatic trials' and 'implementation science'. The two schools of thought developed independently and the paper scrutinises their mutual compatibilities and incompatibilities, asking: i) what do the leading advocates of pragmatic trials assume about the transfer of research findings to real-world practice and ii) what role pragmatic trials can and should play in the evaluation of implementation science strategies. METHODS The paper utilises 'explication de texte': i) providing a close reading of the inferential logics contained in major published expositions of the two paradigms, and ii) interrogating the conclusions of a pragmatic trial of an intervention providing guidelines on retinal screening aimed at family practitioners. RESULTS The paper is in two parts. Part 1 unearths some significant incommensurability - the pragmatic trial literature retains an antiquated view of knowledge transfer and is overly optimistic about the wide applicability the findings of pragmatic trials to 'real world' conditions. Part 2 of the paper outlines an empirical strategy to better penetrate the mechanisms of knowledge transfer and to tackle the issue of the generalisabilty of research findings in implementation science. CONCLUSIONS Pragmatism, classically, is about problem solving and the melding of perspectives. The core research requirement in implementation science is a fundamental shift from the narrow shoulders of pragmatic trials to a model of explanation building based upon a multi-case, multi-method body of evidence.

中文翻译：

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务实试验和实施科学：离婚的理由？

背景技术本文以简短的历史作为开篇，简要介绍了近期临床研究中功利主义转向的两个主要知识要素，即“实用主义试验”和“实施科学”。两种思想流派是独立发展的，本文仔细研究了它们的相互兼容和不兼容之处，并提出以下问题：i）实用试验的主要倡导者对将研究结果转移到现实世界实践中承担了什么责任； ii）实用试验可以起到什么作用，以及应该在执行科学策略的评估中发挥作用。方法本文利用“文本表达”：i）仔细阅读了两种范例的主要公开论述中所包含的推论逻辑，ii）审视一项干预措施的实用试验的结论，该干预措施为针对家庭医生的视网膜筛查提供了指南。结果本文分为两部分。第1部分揭示了一些重大的不可通约性-实用试验文献保留了过时的知识转移观点，并对实用试验的发现在“现实世界”条件下的广泛适用性过于乐观。本文的第2部分概述了一种经验策略，以更好地渗透知识转移的机制并解决实施科学中研究成果的普遍性问题。结论实用主义在传统上是关于解决问题和融合观点的。