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Clinical trials that are designed to help inform practice in the real world are known as pragmatic trials. They are usually characterized by a focus on practical aspects of the study design, including the recruitment and consent process in adherence, as well as 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 vital for a pragmatic trial to be valid and lessen the chance of bias is also essential. A high degree of heterogeneity, however could cause issues with the design of the trial.

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Legality

Pragmatic Play has earned a name for itself by providing high-quality games and a superior user experience. Its software is designed to work with mobile devices and supports different languages. It has been recognized as one of the most popular gaming platforms in the casino industry despite its relatively young age. Wolves is one of the latest games which is a five-reel slot machine that has a high RTP and stunning graphics. The other notable titles include Wolf Gold and Chilli Heat.

The purpose of pragmatic trials is to replicate real-life situations and achieve maximum credibility externally. They are usually requested by policy makers and practitioners to inform their decision making. They can also be a great way to identify the causality between the intervention and its effects. However, they should not be used as a substitute for the use of explanation studies.

The pragmatism idea is controversial and there are doubts regarding whether pragmatic trials could replace tests for explanations or if they should be an alternative to them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which validate a physiological or clinical hypothesis as well as pragmatic trials, which inform policy and practice decisions. They also suggested an approach to pragmatic trials, which they called PRECIS.2 This tool was designed to define the characteristics of a practical trial which includes recruitment, design and delivery of the intervention, as well as monitoring.

The number of pragmatic trials is increasing. A recent Medline search using the keywords naturalistic and pragmatic, limited to controlled trials randomized to control (RCTs) resulted in 34 articles, shown in red in Figure 2. This indicates that the health sciences community is becoming 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.