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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 which include the recruitment process and consent, adhering and the use routinely available equipment.
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Pragmatic is a software company provides a variety of casino games to online gambling platforms. Its iGaming software is used by the top operators as well as land-based casinos. The company offers front-end website design tools, analysis and promotions, marketing, security payment systems, customer support and bug reporting. Additionally, the company provides its players a secure environment with high-quality graphics and gaming.
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Another example of a pragmatic trial is the Home Blood Pressure Management (HBPM) study, which utilized different investigators and had participants from various geographical areas. This kind of heterogeneity is required for pragmatic trials to be valid and also helps to reduce bias in the results. However excessive heterogeneity could result in problems with the design of the trial.
Pragmatic Play Pragmatic Play, one of the major players in the live casino market, provides various classic table games, including Blackjack and Roulette. Pragmatic Play's live studios in Romania and Malta provide a genuine gambling experience for players, as well as a wide range of virtual betting options. The company also has several games that make online gambling more fun and interactive. Some of these shows feature live hosts, while others are hosted by prominent personalities from the industry.
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Pragmatic trials aim to mimic real-life settings and achieve maximum external validity. They are usually requested by policy makers and practitioners to aid in their decision-making. They can also be used to assess the causal relationship between an intervention with its outcomes. However, they should not be used to substitute for explanatory trials.
The pragmatism concept is controversial, and there are questions about whether pragmatic trials should replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which prove a physiological or clinical hypothesis, and pragmatic trials that inform policy and practice decisions. They also suggested a framework for pragmatic trials, which they called PRECIS.2 This tool was designed to define the elements of a practical trial which includes recruitment, design and delivery of the intervention, and follow-up.
There is a growing increase in the number pragmatic trials that have been published. A recent Medline query using the keywords naturalistic and pragmatic, restricted to randomised controlled trials (RCTs), returned 34 articles. These are highlighted in red on Figure 2. This suggests that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to note, however, that the majority were conducted in primary care settings.