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Clinical trials that are designed to help inform practice in the real world are known as pragmatic trials. They are often characterized by their focus on practical aspects of design that include the recruitment process and consent, adhering and the use routinely 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 type of heterogeneity that is crucial for a pragmatic trial to be reliable and lessen the chance of bias is also essential. However too much heterogeneity could result in issues with the design of the trial.

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Pragmatic Play is known for its top-notch games, and for providing a superior user experience. Its software can be used on mobile devices and in multiple languages. It has earned itself the status of one of the leading gaming platforms for casinos despite its relative youth. Wolves is one of the most recent releases, a 5-reel slot machine that has a high RTP and impressive graphics. Other notable titles include Wolf Gold and Chilli Heat.

The purpose of pragmatic trials is to mimic real-life situations and achieve maximum credibility externally. They are typically commissioned by policy makers and practitioners to guide their decision-making. They can also be a great way to identify the causal relationship between the intervention and its effects. However, they should not be used to substitute for the use of explanation trials.

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 suggested the distinction between explanation trials, which validate the validity of a clinical or physiological hypothesis, and pragmatic trials that inform the practice and policy decisions. They also suggested an approach to pragmatic trials, called PRECIS.2 This tool was designed to define the characteristics of a practical trial which includes the recruitment process, the design and implementation of the intervention, as well as follow-up.

The number of pragmatic trials is growing. A recent Medline search using the keywords naturalistic and pragmatic, limited to controlled trials that are randomized (RCTs) produced 34 articles, shown in red in Figure 2. This is a sign that the health sciences community is becoming more acquaint to the subject of pragmatism. It is important to remember, however, that the majority of these studies were conducted in primary-care settings.