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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 usually characterized by a focus on the practical aspects of study design, including the recruitment process and consent as well as adherence to the use of routinely available equipment.

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A practical trial that employs different investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity, that is crucial for a pragmatic trial to be valid and lessen the chance of bias is also essential. Too much heterogeneity, however, can cause problems with the design of the trial.

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Pragmatic Play is renowned for its top-quality games and for offering an exceptional user experience. Its software is designed to work on mobile devices and is compatible with multiple languages. It has established itself as one of the most popular gaming platforms for casinos despite its relatively young age. Wolves is one of its latest releases, a 5-reel slot machine with a healthy RTP and impressive graphics. Its other notable titles are Wolf Gold and Chilli Heat.

Pragmatic trials are designed to replicate real-life settings and achieve maximum external validity. They are typically requested by practitioners and policymakers to help inform their decisions. They are also a good method to determine the causal relationship between the intervention and its effects. However, they should not be used to substitute for explanatory studies.

The concept of pragmatism is controversial, and there are concerns about whether pragmatic trials should replace explanatory trials or complement them. Schwartz and Lellouch1 proposed the distinction between explanation studies, which support a physiological hypothesis or clinical hypothesis, as well as pragmatic trials, which inform policy and practice decision-making. They also proposed the framework for pragmatic trials, which they called PRECIS.2 This tool was designed to define the elements of a pragmatic study that include recruitment, design and delivery of the intervention, as well as follow-up.

There is an encouraging increase in the number pragmatic trials that have been published. A recent Medline query that used the words naturalistic and pragmatic, restricted to randomised controlled trials (RCTs) returned 34 articles. These are highlighted in red on Figure 2. This indicates that the health sciences community is becoming increasingly sensitized to the issue of pragmatics. It is important to keep in mind, however, that the majority of these studies were conducted in primary-care settings.