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Clinical trials that are designed to help inform practice in the real world are referred to as pragmatic trials. They are often characterized by a focus on the practical aspects of the study design, such as the recruitment and consent process as well as adherence to the use of standard equipment.

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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which utilized various investigators and included participants from various geographical areas. This type of heterogeneity is necessary for pragmatic trials to be valid and also helps to reduce the chance of bias in the results. A high degree of heterogeneity, however can result in problems with the trial design.

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Pragmatic Play is renowned for its top-quality games and also for providing an outstanding user experience. Its software is accessible on mobile devices and in multiple languages. Despite its relative youth, it has already established itself as a premier casino gaming platform. The most recent releases include Wolves which is a five-reel video slot with a healthy RTP and stunning graphics. Its other notable titles are Wolf Gold and Chilli Heat.

Pragmatic trials seek to replicate real-world situations and have the highest external validity. They are usually commissioned by policy makers and practitioners to guide their decision-making. They can also be used to determine the cause-effect relationship of an intervention with its outcomes. However, they should not be used in lieu for the use of explanation trials.

The idea of pragmatism is controversial, and there are questions regarding whether pragmatic trials could be used to replace explanation tests or if they are an alternative to them. Schwartz and Lellouch1 suggested a distinction between explanatory trials, which prove the validity of a clinical or physiological hypothesis and pragmatic trials, which inform policy and practice decisions. They also proposed a framework for pragmatic trials, dubbed PRECIS.2 This tool was designed to define the features of a pragmatic trial that include the recruitment process, the design and delivery of the intervention, as well as monitoring.

The number of pragmatic trials is growing. A recent Medline search using the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs), returned 34 articles. They are displayed in red on Figure 2. This is an indication that the health science community is becoming more acquaint to the issue of pragmatics. It is important to remember that the majority were conducted in primary-care settings.