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Clinical trials that are designed to help inform practice in the real world are referred to as 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 routinely available equipment.

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A pragmatic trial that uses a variety investigators and includes participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This type of heterogeneity is required for practical trials to be valid and reduces the chance of bias in the results. However too much heterogeneity could result in issues with the design of the trial.

Pragmatic Play Pragmatic Play, a major player on the live casino market, offers a variety of classic table games such as Blackjack and Roulette. The company's live studios in Romania and Malta provide a genuine gambling experience for players, as well as an extensive selection of virtual betting options. The company has also created various interactive games to make gambling online enjoyable. Some of these shows feature a live host, while others are hosted by famous personalities from the industry.

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Pragmatic Play has gained a reputation for offering top-notch games and an exceptional user experience. Its software can be used on mobile devices and in a variety of languages. Despite its infancy it has already established itself as a premier gaming platform for casinos. Wolves is one of the most recent releases which is a five-reel slot machine that has a high RTP and stunning graphics. Other notable titles include Wolf Gold and Chilli Heat.

The goal of pragmatic trials is to replicate real-life scenarios and gain maximum credibility externally. They are typically commissioned by policy makers and practitioners to aid in their decision-making. They can also be a great method of determining the causality between an intervention and its outcomes. However, they should not be used to replace the need for explanation studies.

The pragmatism idea is controversial, and there are concerns about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 made an distinction between explanation-based studies, which confirm a physiological hypothesis or clinical hypothesis, as well as pragmatic trials that aid in policy and practice decision-making. They also proposed a framework called PRECIS for pragmatic trials.2 This tool tried to define the characteristics of a pragmatic research study that includes the recruitment, design, and delivery of the intervention and its follow-up.

There is a positive increase in the number pragmatic trials published. A recent Medline search using the keywords pragmatic and naturalistic, restricted to randomized controlled trials (RCTs) produced 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 issue of pragmatics. It is important to remember that the majority of these trials were conducted in primary care settings.