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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 design, including the recruitment process and consent, adhering and the use routinely available equipment.

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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which used various investigators and included participants from different geographic areas. This kind of heterogeneity, that is crucial for a pragmatic trial to be reliable and to reduce bias in the results, is also necessary. However excessive heterogeneity could lead to issues with the design of the trial.

Pragmatic Play, one of the biggest players on the live casino market, offers various classic table games, including Blackjack and Roulette. Pragmatic Play's live studios in Romania and Malta offer an authentic gaming experience for its customers, as well as a full suite of virtual betting options. The company also has created numerous interactive game shows that make online gambling enjoyable. Some of these shows feature a live host, while others are hosted by prominent personalities from the industry.

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The purpose of pragmatic trials is to simulate real-life situations and achieve the highest level of validity externally. They are typically commissioned by policy makers and practitioners to aid in their decision-making. They can also be a great way to identify the cause-effect relationship between an intervention and its outcomes. However, they shouldn't be used in lieu for explanatory trials.

The idea of pragmatism is controversial and there are doubts about whether pragmatic trials can be used to replace explanation tests or if they are an addition to them. Schwartz and Lellouch1 suggested a distinction between explanatory studies, which prove the validity of a physiological or clinical hypothesis, and pragmatic trials, that inform policy and practice decision-making. They also suggested a framework for pragmatic trials, dubbed PRECIS.2 This tool sought to define the features of a pragmatic trial that include recruitment, design and delivery of the intervention, and follow-up.

The number of pragmatic trials is increasing. A recent Medline query that used the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs), returned 34 articles. These are highlighted in red on Figure 2. This is an indication that the health sciences community is becoming increasingly sensitized to the subject of pragmatism. However, it is important to remember that the majority of these trials were conducted in primary care settings.