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Pragmatic trials are trials designed to inform real-world clinical practice. They are typically characterized by a focus on practical aspects of the research design, like the recruitment and consent process in adherence, as well as the use of commonly available equipment.
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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which utilized a variety of investigators and had participants from different geographical regions. This kind of heterogeneity, that is crucial for pragmatic trials to be valid and lessen the chance of bias, is also necessary. Too much heterogeneity, however could cause issues with the design of the trial.
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Pragmatic Play has earned a name for itself by providing high-quality games and a superior user experience. The software is available on mobile devices as well as in various languages. It has earned itself the status of one of the top casino gaming platforms despite its relatively young age. Wolves is one of the most recent releases that is a 5-reel slot machine that has a high RTP and impressive graphics. The other notable titles include Wolf Gold and Chilli Heat.
Pragmatic trials aim to mimic real-life settings and achieve maximum external validity. They are usually requested by practitioners and policy makers to guide their decision-making. They can also be used to determine the causal relationship between an intervention with its outcomes. They should not, however be used to replace explanation studies.
The idea of pragmatism is controversial and there are concerns about whether pragmatic trials can replace explanatory tests or if they should serve as a complement to them. Schwartz and Lellouch1 made a distinction between explanatory studies, which prove a physiological hypothesis or clinical hypothesis, as well as pragmatic trials, that inform the practice and policy decision-making. They also suggested an approach to pragmatic trials, called PRECIS.2 This tool was designed to define the elements of a pragmatic study, including the recruitment process, the design and implementation of the intervention, as well as follow-up.
The number of pragmatic trials is increasing. A recent Medline query using the keywords pragmatic and naturalistic, limited to randomised controlled trials (RCTs), returned 34 articles. These are shown in red on Figure 2. This indicates that the health science community is becoming more sensitive to the subject of pragmatism. However, it is important to note that the majority of these trials were conducted in primary care settings.