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Studies designed to provide insight into clinical practice in the real world are known as pragmatic trials. They are often characterized as a focus on the practical aspects of designing a study, including the recruitment process and consent, adhering and the use of 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 is required for pragmatic trials to be able to prove their validity and also reduces bias in the results. However excessive heterogeneity could result in issues with the design of the trial.

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Legality

Pragmatic Play is renowned for its top-quality games and also for providing an outstanding user experience. Its software is accessible on mobile devices and in a variety of languages. Despite its relatively young age it has already established itself as a top gaming platform for casinos. Wolves is one of its latest releases that is a 5-reel slot machine with a hefty RTP and impressive graphics. Other notable titles include Wolf Gold and Chilli Heat.

Pragmatic trials are designed to replicate real-world situations and have the highest external validity. They are typically commissioned by practitioners and policy makers to inform their decision making. They can also be a great method of determining the causal relationship between an intervention and its outcomes. However, they should not, be used to replace explanatory studies.

The concept of pragmatism is controversial, and there are questions regarding whether pragmatic trials could replace explanatory tests or if they should serve as a complement to them. Schwartz and Lellouch1 made a distinction between explanatory studies, which support a physiological hypothesis or clinical hypothesis, as well as pragmatic trials, which inform the decision-making process for policy and practice. They also suggested a framework dubbed PRECIS for pragmatic trials.2 This tool attempted to define the elements of a pragmatic study, including recruitment, design, implementation of the intervention and follow-up.

There is a positive increase in the number pragmatic trials that have been published. A recent Medline query using the keywords naturalistic and pragmatic, restricted to randomised controlled trials (RCTs) returned 34 articles. These are shown in red on Figure 2. This indicates 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 trials were conducted in primary care settings.