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Trials designed to inform clinical practice in the real world are referred to as pragmatic trials. They are often characterized as a focus on the practical aspects of study design, including the recruitment and consent process, as well as adherence and the use routinely 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 included participants from different geographic areas. This type of heterogeneity that is crucial for pragmatic trials to be valid and reduce bias in results is also essential. A high degree of heterogeneity, however, can cause problems with the trial design.
Pragmatic Play Pragmatic Play, a major player on the live casino market, provides an array of traditional table games, including Blackjack and Roulette. The company's live studios in Romania and Malta offer an authentic gambling experience for players, as well as a wide range of virtual betting options. The company has also created several interactive game shows to make gambling online enjoyable. Some of these shows are telecast live, while others are hosted by famous personalities from the field.
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Pragmatic trials aim to mimic real-life settings and achieve maximum external validity. They are typically commissioned by policy makers and practitioners to inform their decision making. They can be used to determine the causal relationship between an intervention and its results. However, they shouldn't be used to substitute for explanatory studies.
The concept of pragmatism is controversial, and there are questions about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 proposed a distinction between explanatory studies, which confirm a physiological hypothesis or clinical hypothesis, as well as pragmatic trials, that inform the practice and policy decision-making. They also proposed the framework for pragmatic trials, dubbed PRECIS.2 This tool sought to define the features of a practical trial which includes recruitment, design and delivery of the intervention, as well as the follow-up.
The number of pragmatic trials is increasing. A recent Medline search using the terms pragmatic and naturalistic, restricted to controlled trials that are randomized (RCTs) produced 34 articles, which are shown in red in Figure 2. This is a sign that the health science community is becoming more acquaint to the subject of pragmatism. It is important to remember, however, that the majority of these studies were conducted in primary-care settings.