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Pragmatic trials are those that are designed to inform real-world clinical practice. They are usually characterized by a focus on the practical aspects of the study design, including recruitment and consent, adherence, and the use of standard equipment.

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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which utilized different investigators and participants from various geographical areas. This type of heterogeneity, which is vital for pragmatic trials to be valid and lessen the chance of bias, is also necessary. However, too much heterogeneity can result in problems with the trial design.

Pragmatic Play Pragmatic Play, one of the biggest players on the live casino market offers a variety of classic table games, including Blackjack and Roulette. The live studios of Pragmatic Play in Romania and Malta offer customers an authentic gaming experience as well a full range of virtual betting options. The company also has created several interactive game shows to make online gambling fun. Some of these shows are hosted live and others feature famous personalities in the field.

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Pragmatic trials aim to mimic real-life settings and achieve maximum external validity. They are usually requested by practitioners and policy makers to aid in their decision-making. They also provide a useful method to determine the causality between the intervention and its effects. However, they shouldn't be used in lieu for explanation trials.

The pragmatism idea is controversial and there are doubts about whether pragmatic trials can replace explanatory tests or if they should serve as a complement to them. Schwartz and Lellouch1 suggested an distinction between explanation-based studies, which confirm the validity of a physiological or clinical hypothesis, as well as pragmatic trials that aid in the decision-making process for policy and practice. They also suggested a framework dubbed PRECIS for pragmatic trials.2 This tool attempted to define the characteristics of a pragmatic study which includes recruitment, design, delivery of the intervention and its follow-up.

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