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Pragmatic trials are studies designed to inform the practice of clinical trials in real life. They are typically described by their focus on practical aspects of designing a study which include the recruitment process and consent, adhering and the use routinely available equipment.

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Pragmatic is a software developer that provides a variety of casino games on online gambling platforms. Its iGaming solutions are used by the leading operators and land-based casinos. The company offers front-end design tools, analysis tools, marketing, promotions and payment systems, as well as security, customer service, and bug reporting. The company also offers an environment that is safe and secure with high-quality graphics, games and security.

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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which used a variety of investigators and participants from different geographic areas. This type of heterogeneity is necessary for practical trials to be valid, and it also helps reduce bias in the results. Too much heterogeneity, however can result in problems with the design of the trial.

Pragmatic Play Pragmatic Play, one of the biggest players on the live casino market offers an array of traditional table games like Blackjack and Roulette. The live studios of the company in Romania and Malta offer a real-life gaming experience for its customers and offer a wide range of virtual betting options. The company has also developed various interactive games to make gambling online enjoyable. Some of these shows are hosted live, while others are hosted by famous personalities from the field.

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Pragmatic trials seek to replicate real-world situations and have the highest external validity. They are usually commissioned by practitioners and policy makers to guide their decision-making. They are also a good way to identify the causality between an intervention and its outcomes. They should not, however, be used to replace the need for explanation studies.

The pragmatism concept is controversial and there are doubts about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 proposed an distinction between explanation-based studies, which prove the validity of a physiological or clinical hypothesis, and pragmatic trials, that inform policy and practice decision-making. They also suggested the framework for pragmatic trials, called PRECIS.2 This tool was designed to define the elements of a pragmatic trial, including the recruitment process, the design and delivery of the intervention, as well as monitoring.

There is a positive increase in the number of pragmatic trials published. A recent Medline search using the words naturalistic and pragmatic, restricted to randomised controlled trials (RCTs) returned 34 articles. They are displayed in red on Figure 2. This is an indication that the health science community is becoming more acquaint to the issue of pragmatics. It is important to note that the majority of these trials were conducted in primary care settings.