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Trials designed to inform clinical practice in the real world are known as pragmatic trials. They are typically described as focusing on practical aspects of design that include the recruitment process and consent, adhering and the use of standard equipment.
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A pragmatic study that involves different investigators and participants from different geographical areas is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is required for pragmatic trials to be able to prove their validity and helps reduce the chance of bias in the results. Too much heterogeneity, however, can cause problems with the trial design.
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Pragmatic Play has gained a reputation for offering top-quality games and an outstanding user experience. Its software is designed to work with mobile devices and supports different languages. Despite its relative youth it has established itself as a top gaming platform for casinos. Wolves is one of the latest games that is a 5-reel slot machine with a hefty RTP and impressive graphics. Other notable titles include Wolf Gold and Chilli Heat.
The aim of pragmatic trials is to replicate real-life scenarios and gain the highest level of validity externally. They are typically commissioned by policymakers and practitioners in order to guide their decisions. They can also be used to determine the causality of an intervention with its outcomes. However, they shouldn't be used in lieu for explanatory trials.
The pragmatism concept is controversial, and there are questions about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which validate the validity of a clinical or physiological hypothesis as well as pragmatic trials, which inform the practice and policy decisions. They also proposed the framework for pragmatic trials, dubbed PRECIS.2 This tool sought to define the features of a pragmatic trial which includes the recruitment process, the design and delivery of the intervention, and monitoring.
There is an encouraging increase in the number pragmatic trials published. A recent Medline query that used the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs) returned 34 articles. These are shown in red on Figure 2. This suggests 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.