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Studies designed to provide insight into clinical practice in the real world are called pragmatic trials. They are usually focused on the practical aspects of study design, including the recruitment and consent process in adherence, as well as the use of 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 necessary for pragmatic trials to be valid and also reduces bias in the results. However, too much heterogeneity can result in problems with the trial design.

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Pragmatic Play is renowned for its top-quality games and also for providing an outstanding user experience. The software is available on mobile devices and in a variety of languages. It has established itself as one of the top gaming platforms in the casino industry despite its relatively young age. The latest releases include Wolves 5 reel video slot with a healthy RTP and impressive graphics. Other notable titles include Wolf Gold and Chilli Heat.

Pragmatic trials are designed to replicate real-life settings and achieve maximum external validity. They are usually commissioned by practitioners and policy makers to inform their decision making. They are also a good way to identify the cause-effect relationship between an intervention and its results. However, they should not, be used to replace the need for explanation studies.

The concept of pragmatism is controversial and there are doubts about whether pragmatic trials should replace explanatory trials or complement them. Schwartz and Lellouch1 suggested a distinction between explanatory studies, which support the validity of a physiological or clinical hypothesis, as well as pragmatic trials that aid in policy and practice decision-making. They also suggested a framework dubbed PRECIS for pragmatic trials.2 This tool attempted to define the elements of a pragmatic research study, including the recruitment, design, and delivery of the intervention and follow-up.

There is an encouraging increase in the number pragmatic trials published. A recent Medline search using the terms naturalistic and pragmatic, limited to controlled trials randomized to control (RCTs) resulted in 34 articles, which are shown in red in Figure 2. This indicates that the health sciences community has become more aware of the importance of pragmatism. However, it is important to remember that the majority of these studies were conducted in primary care settings.