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Clinical trials that are designed to help inform practice in the real world are called pragmatic trials. They are typically described by their focus on practical aspects of designing a study that include recruitment and consent, adherence and the use of standard equipment.

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A pragmatic study that involves different investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This type of heterogeneity, that is crucial for pragmatic trials to be reliable and lessen the chance of bias is also essential. However, too much heterogeneity, can cause problems with the trial design.

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Pragmatic Play is known for its top-quality games and for providing a superior user experience. Its software is designed to work with mobile devices and is compatible with various languages. Despite its relative youth it has established itself as a top casino gaming platform. Wolves is one of its latest releases which is a five-reel slot machine that has a high RTP and impressive graphics. Other notable games include Wolf Gold and Chilli Heat.

Pragmatic trials are designed to replicate real-life situations and attain maximum external validity. They are usually commissioned by policy makers and practitioners to guide their decision-making. They are also a good way to identify the causal relationship between an intervention and its results. They should, however, not, be used to replace explanation studies.

The pragmatism idea is controversial, and there are questions about whether pragmatic trials should replace tests for explanations or if they should be an addition to them. Schwartz and Lellouch1 suggested a distinction between explanatory trials, which confirm the clinical or physiological hypothesis, and pragmatic trials, which inform the policy and practice of. They also proposed a framework for pragmatic trials, called PRECIS.2 This tool sought to define the features of a practical trial which includes recruitment, design and delivery of the intervention, and the follow-up.

The number of pragmatic trials is growing. A recent Medline query that used the words pragmatic and naturalistic, which was restricted to randomised controlled trials (RCTs) returned 34 articles. These are highlighted in red on Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatism. However, it is important to keep in mind that the majority of these trials were conducted in primary care settings.