Fig. 4

The PRIME-9 collaboration. The PRIME-9 collaboration is an international network of healthcare professionals and researchers who are collaborating to conduct pragmatic clinical trials. This collaboration includes nine countries, namely Sweden, Canada, Denmark, the UK, the USA, Netherlands, Germany, Australia, and New Zealand. The objective of the PRIME-9 collaboration is to investigate vital clinical questions by conducting extensive, real-world studies that represent the diversity of patients and healthcare settings. Pragmatic clinical trials concentrate on the effectiveness of interventions in real-world settings rather than the efficacy of interventions in controlled environments. By conducting these trials, the PRIME-9 collaboration seeks to provide valuable insights into the best practices for treating and managing various health conditions. The partnership includes a multidisciplinary team of researchers, clinicians, and patient advocates working together to design and execute relevant and meaningful studies for patients and healthcare providers. Country-level pragmatic RCTs will be pooled into a master-level RCT, allowing the PRIME-9 collaboration to conduct studies on a larger scale and more efficiently than individual research teams