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Pragmatic trials are those that are designed to provide information for the practice of clinical trials in real life. They are usually focused on practical aspects of the study design, including the recruitment process and consent in adherence, as well as the use of standard equipment.

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A pragmatic study that involves various investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is necessary for pragmatic trials to be able to prove their validity and also helps reduce the chance of bias in the results. However, too much heterogeneity can lead to problems with the design of the trial.

Pragmatic Play Pragmatic Play, a major player on the live casino market offers an array of traditional table games, including Blackjack and Roulette. The live studios of the company in Romania and Malta offer an authentic gambling experience for players, as well as a wide range of virtual betting options. The company also offers a variety of game shows which make online gambling exciting and interactive. Some of these shows have live hosts, while others are hosted by prominent personalities from the industry.

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Pragmatic Play offers not only mobile-friendly slot machines as well as live casino and table games. The company is licensed by a variety of regulatory bodies such as Malta Gaming Authority and UK Gambling Commission. The games are protected by top-of-the-line encryption technology and the security team is available to assist players solve any issues they might have.

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Legality

Pragmatic Play is known for its top-quality games and for providing a superior user experience. Its software can be used on mobile devices and in a variety of languages. Despite its relatively young age it has already established itself as a leading casino gaming platform. Its latest releases include Wolves which is a five-reel video slot with a healthy RTP and stunning graphics. Other notable titles include Wolf Gold and Chilli Heat.

The aim of pragmatic trials is to replicate real-life scenarios and gain maximum credibility externally. They are usually requested by practitioners and policy makers to aid in their decision-making. They also provide a useful method to determine the cause-effect relationship between an intervention and its outcomes. However, they should not be used to substitute for explanation trials.

The pragmatism idea is controversial and there are doubts about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 suggested a distinction between explanatory studies, which prove the validity of a physiological or clinical hypothesis, and pragmatic trials that aid in the decision-making process for policy and practice. They also suggested an approach to pragmatic trials, which they called PRECIS.2 This tool attempted to define the elements of a pragmatic trial which includes the recruitment process, the design and implementation of the intervention, and monitoring.

There is a positive trend in the number of pragmatic trials that have been published. A recent Medline search using the terms pragmatic and naturalistic, restricted to controlled trials that are randomized (RCTs) produced 34 articles, as shown in red in Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatic thinking. However, it is important to keep in mind that the majority of these trials were conducted in primary care settings.