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Pragmatic trials are those that are designed to provide information for real-world clinical practice. They are often characterized by a focus on practical aspects of the study design, such as the recruitment process and consent, adherence, and the use of routinely available equipment.
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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which employed a variety of investigators and included participants from various geographical areas. This kind of heterogeneity, that is crucial for pragmatic trials to be reliable and reduce bias in results, is also necessary. Too much heterogeneity, however can result in problems with the trial design.
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Pragmatic Play offers not only mobile-friendly slot machines but also table games and live casino. The company is licensed by a variety of regulatory bodies, including Malta Gaming Authority and UK Gambling Commission. The games offered by the company are secured with high-end encryption and its security staff is on hand to assist players in any situation.
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Pragmatic trials are designed to replicate real-life settings and achieve maximum external validity. They are usually requested by practitioners and policymakers in order to guide their decisions. They are also a good method of determining the causal relationship between an intervention and its outcomes. However, they should not, be used to replace explanatory studies.
The concept of pragmatism is controversial and there are doubts regarding whether pragmatic trials could be used to replace explanation tests or if they should serve as an addition to them. Schwartz and Lellouch1 proposed a distinction between explanatory studies, which support the validity of a physiological or clinical hypothesis, and pragmatic trials, which inform policy and practice decision-making. They also suggested a framework dubbed PRECIS for pragmatic trials.2 This tool tried to define the characteristics of a pragmatic research study that includes recruitment, design, implementation of the intervention, and follow-up.
The number of pragmatic trials is growing. A recent Medline search using the terms naturalistic and pragmatic, limited to controlled trials randomized to control (RCTs), yielded 34 articles, which are shown in red in Figure 2. This is an indication that the health science community is becoming more acquaint to the subject of pragmatic thinking. It is important to keep in mind that the majority of these trials were conducted in primary care settings.