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Clinical trials that are designed to help inform practice in the real world are called pragmatic trials. They are typically described as focusing on practical aspects of designing a study, including the recruitment process and consent, adhering and the use routinely available equipment.

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Pragmatic Software, a software firm offers a range of casino games for online gambling platforms. Pragmatic's iGaming solutions are utilized by the top operators and land-based casinos. The company provides front-end tools for design, analysis, promotions, marketing, payment systems, security, customer support and bug reporting. The company also provides an environment that is safe and secure with high-quality graphics, games and security.

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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which used various investigators and included participants from various geographical areas. This type of heterogeneity that is crucial for a pragmatic trial to be valid and to reduce bias in the results is also essential. However excessive heterogeneity could cause issues with the design of the trial.

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The purpose of pragmatic trials is to mimic real-life scenarios and gain maximum validity externally. They are usually ordered by policymakers and practitioners to help inform their decisions. They can be used to determine the cause-effect relationship of an intervention and its effects. However, they shouldn't be used as a substitute for explanation studies.

The idea of pragmatism is controversial, and there are questions regarding whether pragmatic trials could replace tests for explanations or if they should serve as a complement to them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which validate the clinical or physiological hypothesis as well as pragmatic trials, which inform the practice and policy decisions. They also proposed an approach to pragmatic trials, which they called PRECIS.2 This tool was designed to define the elements of a practical trial that include the recruitment process, the design and implementation of the intervention, as well as the follow-up.

There is a growing increase in the number pragmatic trials that are published. A recent Medline search using the keywords naturalistic and pragmatic, limited to controlled trials randomized to control (RCTs) resulted in 34 articles, shown in red in Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to note, however, that the majority of studies were conducted in primary care settings.