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Studies designed to provide insight into clinical practice in the real world are called pragmatic trials. They are often described as focusing on practical aspects of designing a study that include 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, which is essential for pragmatic trials to be valid and reduce bias in results is also essential. However excessive heterogeneity could lead to issues with the design of the trial.
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Pragmatic Play has earned a name for itself by providing top-quality games and an outstanding user experience. Its software is designed to work with mobile devices and supports various languages. It has been recognized as one of the top gaming platforms for casinos despite its relative infancy. Wolves is one of its latest releases which is a five-reel slot machine with a hefty RTP and impressive graphics. Other notable games include Wolf Gold and Chilli Heat.
Pragmatic trials aim to mimic real-world situations and have the highest external validity. They are usually requested by practitioners and policymakers to guide their decisions. They also provide a useful method to determine the cause-effect relationship between an intervention and its outcomes. They should, however, not, be used to replace explanation studies.
The pragmatism idea is controversial and there are doubts about whether pragmatic trials should replace explanatory tests or if they should be an addition to them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which validate a physiological or clinical hypothesis and pragmatic trials, which inform the policy and practice of. They also suggested the framework for pragmatic trials, dubbed PRECIS.2 This tool attempted to define the features of a pragmatic trial which includes recruitment, design and delivery of the intervention, as well as monitoring.
There is a growing increase in the number of pragmatic trials that have been published. A recent Medline search using the terms naturalistic and pragmatic, which was limited to controlled trials randomized to control (RCTs) resulted in 34 articles, which are shown in red in Figure 2. This is an indication that the health science community is becoming more sensitive to the issue of pragmatic thinking. However, it is important to keep in mind that the majority of these studies were conducted in primary care settings.