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Studies designed to provide insight into clinical practice in the real world are called pragmatic trials. They are often characterized by their focus on practical aspects of designing a study, including recruitment and consent, adherence and the use of standard equipment.
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A pragmatic study that involves a variety investigators and includes participants from various geographical regions is the Home Blood Pressure Management study (HBPM). This type of heterogeneity that is crucial for pragmatic trials to be reliable and reduce bias in results is also essential. However too much heterogeneity could lead to problems with the design of the trial.
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Pragmatic Play offers not only mobile-friendly slot machines, but also live casino and table games. The company is licensed by a variety of regulatory bodies such as Malta Gaming Authority and UK Gambling Commission. The games are supported by top-of-the-line encryption technology, and the company's security team is always on hand to help players resolve any issues they might face.
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Pragmatic trials aim to mimic real-world situations and have the highest external validity. They are usually commissioned by practitioners and policy makers to aid in their decision-making. They can be used to determine the causal relationship between an intervention and its results. However, they shouldn't be used as a substitute for the use of explanation studies.
The concept of pragmatism is controversial and there are concerns about whether pragmatic trials should replace explanatory tests or if they should be a complement to them. Schwartz and Lellouch1 suggested a distinction between explanatory trials, which confirm a physiological or clinical hypothesis and pragmatic trials, which guide the practice and policy decisions. They also suggested a framework known as PRECIS for pragmatic trials.2 The tool was designed to define the elements of a practical study which includes the recruitment, design, and delivery of the intervention, and follow-up.
The number of pragmatic trials is increasing. A recent Medline search using the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs) returned 34 articles. They are displayed in red on Figure 2. This suggests that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to note that the majority of these studies were conducted in primary care settings.