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Trials designed to inform clinical practice in the real world are referred to as pragmatic trials. They are typically described by their focus on practical aspects of design that 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 trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which employed various investigators and included participants from different geographical regions. This type of heterogeneity is essential for pragmatic trials to be able to prove their validity and reduces bias in the results. However, too much heterogeneity could cause issues with the design of the trial.
Pragmatic Play Pragmatic Play, one of the biggest players on the live casino market, offers a variety of classic table games like Blackjack and Roulette. The live studios of the company in Romania and Malta offer a real-life gambling experience for players, as well as a full suite of virtual betting options. The company also has several game shows which make online gambling enjoyable and engaging. Some of these shows feature live hosts, while others are hosted by prominent personalities from the industry.
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Pragmatic trials seek 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 be used to determine the causal relationship between an intervention and its results. However, they shouldn't be used to substitute for explanation studies.
The pragmatism idea is controversial and there are questions about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 made a distinction between explanatory studies, which prove the physiological hypothesis or clinical hypothesis, as well as pragmatic trials that aid in the decision-making process for policy and practice. They also suggested a framework known as PRECIS for pragmatic trials.2 The tool was designed to define the elements of a practical study, including recruitment, design, delivery of the intervention and follow-up.
There is a positive increase in the number of pragmatic trials that are published. A recent Medline search using the terms naturalistic and pragmatic, which was limited to randomized controlled trials (RCTs) produced 34 articles, as shown in red in Figure 2. This suggests that the health sciences community is becoming more aware of the importance of pragmatism. It is important to keep in mind that the majority of these studies were conducted in primary-care settings.