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Pragmatic trials are trials designed to inform the practice of clinical trials in real life. They are typically described as focusing on practical aspects of design that include the recruitment process and consent, adhering and the use of routinely available equipment.
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A pragmatic study that involves different investigators and participants from different geographical areas is the Home Blood Pressure Management study (HBPM). This type of heterogeneity is essential for practical trials to be valid, and it also reduces bias in the results. However, too much heterogeneity can result in problems with the design of the trial.
Pragmatic Play is also a major player on the live casino market, offering an array of table games that are classic such as Blackjack and Roulette in a variety of versions. The live studios of Pragmatic Play's offices in Romania and Malta offer customers an authentic experience in gambling as well as a broad variety of betting options via virtual. The company has also created various interactive games to make online gambling enjoyable. Some of these shows feature live hosts, while others are hosted by prominent personalities from the industry.
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Pragmatic trials seek to replicate real-life situations and attain maximum external validity. They are usually requested by practitioners and policy makers to guide their decision-making. They also provide a useful way to identify the causal relationship between an intervention and its results. However, they should not be used as a substitute for the use of explanation studies.
The concept of pragmatism is controversial and there are doubts regarding whether pragmatic trials could be used to replace explanation tests or if they should be an addition to them. Schwartz and Lellouch1 made an distinction between explanation-based studies, which support a physiological hypothesis or clinical hypothesis, and pragmatic trials, which inform the decision-making process for policy and practice. They also suggested a framework known as PRECIS for pragmatic trials.2 This tool tried to define the traits of a practical study that includes recruitment, design, delivery of the intervention and its follow-up.
The number of pragmatic trials is growing. A recent Medline search using the terms pragmatic and naturalistic, restricted to randomized controlled trials (RCTs), yielded 34 articles, shown in red in Figure 2. This is an indication that the health sciences community is becoming increasingly sensitized to the subject of pragmatic thinking. However, it is important to remember that the majority of these trials were conducted in primary care settings.