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Trials designed to inform clinical practice in the real world are called pragmatic trials. They are often characterized by a focus on practical aspects of the study design, including the recruitment and consent process, adherence, and the use of commonly available equipment.

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A pragmatic trial that uses various investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity, which is essential for a pragmatic trial to be reliable and reduce bias in results is also essential. Too much heterogeneity, however can result in problems with the trial design.

Pragmatic Play, one of the major players in the live casino market offers an array of traditional table games such as Blackjack and Roulette. The live studios of Pragmatic Play's offices in Romania and Malta provide customers with an authentic gambling experience, and a wide selection of virtual betting options. The company has also created numerous interactive game shows that make online gambling fun. Some of these shows are hosted live, while others include famous people from the field.

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Pragmatic Play is renowned for its top-quality games and also for providing an outstanding user experience. The software is available on mobile devices as well as in various languages. It has been recognized as one of the leading casino gaming platforms despite its relative youth. Wolves is one of the latest games which is a five-reel slot machine that has a high RTP and stunning graphics. Its other notable titles are Wolf Gold and Chilli Heat.

The goal of pragmatic trials is to simulate real-life scenarios and to achieve the highest level of validity externally. They are usually requested by policy makers and practitioners to aid in their decision-making. They can also be used to determine the cause-effect relationship of an intervention and its results. They should, however, not be used to replace explanation studies.

The idea of pragmatism is controversial and there are concerns regarding whether pragmatic trials could replace tests for explanations or if they should serve as a complement to them. Schwartz and Lellouch1 made a distinction between explanatory studies, which confirm the validity of a physiological or clinical hypothesis, and pragmatic trials, which inform the practice and policy decision-making. They also suggested a framework known as PRECIS for pragmatic trials.2 This tool tried to define the traits of a pragmatic study which includes recruitment, design, implementation of the intervention and follow-up.

There is a positive increase in the number of pragmatic trials that have been published. A recent Medline search using the terms naturalistic and pragmatic, which was limited to controlled trials that are randomized (RCTs) produced 34 articles, shown in red in Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to remember, however, that the majority were conducted in primary care settings.