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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 focused on the practical aspects of the study design, such as recruitment and consent, adherence, and the use of routinely available equipment.

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A pragmatic study that involves different investigators and participants from various geographical regions is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is necessary for practical trials to be valid, and it also helps reduce bias in the results. Too much heterogeneity, however can result in problems with the trial design.

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Legality

Pragmatic Play is known for its top-notch games, and for offering an exceptional user experience. Its software is designed to work with mobile devices and supports different languages. It has been recognized as one of the leading gaming platforms in the casino industry despite its relative infancy. Its latest releases include Wolves 5 reel video slot that has a healthy RTP and stunning graphics. Its other notable titles are Wolf Gold and Chilli Heat.

Pragmatic trials are designed to replicate real-world situations and have the highest external validity. They are usually requested by practitioners and policymakers in order to guide their decisions. They can also be used to assess the causal relationship between an intervention and its effects. They should, however, not be used to replace explanatory studies.

The pragmatism concept is controversial and there are questions about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 proposed the distinction between explanation studies, which support the physiological hypothesis or clinical hypothesis, as well as pragmatic trials, that inform the practice and policy decision-making. They also proposed an approach to pragmatic trials, which they called PRECIS.2 This tool sought to define the features of a pragmatic study that include recruitment, design and delivery of the intervention, as well as monitoring.

There is a growing increase in the number pragmatic trials that are published. A recent Medline query that used the words pragmatic and naturalistic, which was restricted to randomised controlled trials (RCTs), returned 34 articles. These are highlighted in red on Figure 2. This suggests that the health sciences community is becoming more aware of the importance of pragmatic thinking. However, it is important to keep in mind that the majority of these trials were conducted in primary care settings.