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Clinical trials that are designed to help inform practice in the real world are called pragmatic trials. They are often characterized as focusing on practical aspects of study design which include the recruitment and consent process, as well as adherence and the use of routinely available equipment.

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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which utilized various investigators and participants from various geographical areas. This type of heterogeneity which is vital for pragmatic trials to be reliable and to reduce bias in the results is also essential. However, too much heterogeneity can lead to issues with the design of the trial.

Pragmatic Play is also a major player on the live casino market, providing an array of classic table games such as Blackjack and Roulette in a variety of versions. The live studios of Pragmatic Play's offices in Romania and Malta provide customers with an authentic gambling experience, as well a full variety of betting options via virtual. The company also hosts a variety of game shows that make online gambling more fun and interactive. Some of these shows have live hosts, while others are hosted by prominent personalities from the industry.

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Pragmatic Play has gained a reputation for offering top-notch games and an exceptional user experience. Its software is designed to work with mobile devices and is compatible with multiple languages. It has been recognized as one of the most popular gaming platforms in the casino industry despite its relative youth. Wolves is one of the most recent releases which is a five-reel slot machine with a hefty RTP and stunning graphics. Its other notable titles are Wolf Gold and Chilli Heat.

The purpose of pragmatic trials is to replicate real-life scenarios and gain the highest level of validity externally. They are usually ordered by policymakers and practitioners to guide their decisions. They can also be a great method of determining the causal relationship between an intervention and its outcomes. However, they shouldn't be used as a substitute for explanation studies.

The pragmatism concept is controversial, and there are questions about whether pragmatic trials should replace explanatory trials or complement them. Schwartz and Lellouch1 made an distinction between explanation-based studies, which prove the validity of a physiological or clinical hypothesis, as well as pragmatic trials, which inform policy and practice decision-making. They also proposed a framework for pragmatic trials, which they called PRECIS.2 This tool attempted to define the features of a pragmatic trial which includes the recruitment process, the design and delivery of the intervention, and the follow-up.

There is an encouraging increase in the number pragmatic trials that have been published. A recent Medline search using the terms naturalistic and pragmatic, limited to controlled trials that are randomized (RCTs), yielded 34 articles, as 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 keep in mind that the majority of these trials were conducted in primary care settings.