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Clinical trials that are designed to help inform practice in the real world are referred to as pragmatic trials. They are typically focused on practical aspects of the study design, such as the recruitment process and consent, adherence, and the use of standard equipment.

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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which utilized a variety of investigators and included participants from various geographical areas. This kind of heterogeneity, which is essential for pragmatic trials to be valid and to reduce bias in the results, is also necessary. A high degree of heterogeneity, however can result in problems with the design of the trial.

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Pragmatic Play is known for its top-quality games and for offering an exceptional user experience. Its software can be used on mobile devices and in multiple languages. It has established itself as one of the top gaming platforms for casinos despite its relative infancy. Wolves is one of the most recent releases that is a 5-reel slot machine with a healthy RTP and impressive graphics. Other notable titles include Wolf Gold and Chilli Heat.

Pragmatic trials aim to mimic real-life settings and achieve maximum external validity. They are typically commissioned by practitioners and policy makers to guide their decision-making. They can be used to determine the causal relationship between an intervention with its outcomes. However, they should not, be used to replace the need for explanation studies.

The pragmatism idea is controversial, and there are questions about whether pragmatic trials can be used to replace explanation tests or if they should be an alternative to them. Schwartz and Lellouch1 proposed a distinction between explanatory studies, which confirm the physiological hypothesis or clinical hypothesis, as well as pragmatic trials that aid in the practice and policy decision-making. They also proposed an approach to pragmatic trials, dubbed PRECIS.2 This tool was designed to define the characteristics of a practical trial, including the recruitment process, the design and implementation of the intervention, as well as the follow-up.

The number of pragmatic trials is increasing. A recent Medline search using the words naturalistic and pragmatic, restricted to randomised controlled trials (RCTs), returned 34 articles. These are highlighted in red on Figure 2. This is an indication that the health sciences community is becoming increasingly sensitized to the issue of pragmatism. It is important to note that the majority of these studies were conducted in primary care settings.