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Trials designed to inform clinical practice in the real world are called pragmatic trials. They are often described as focusing on practical aspects of study design that include the recruitment process and consent, adhering and the use routinely available equipment.
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Pragmatic is a software developer that provides a variety of casino games on online gambling platforms. Pragmatic's iGaming solutions are utilized by the leading operators and land-based casinos. The company offers front-end site design tools, analysis tools and promotions, marketing, security, payment systems, customer service and bug-reporting. In addition, the company provides its users a safe environment with high-quality graphics and games.
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A practical trial that employs a variety investigators and includes participants from various geographical regions is the Home Blood Pressure Management study (HBPM). This type of heterogeneity is essential for practical trials to be valid, and it also reduces the chance of bias in the results. However, too much heterogeneity, can cause problems with the design of the trial.
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The goal of pragmatic trials is to replicate real-life situations and achieve maximum credibility externally. They are usually requested by policy makers and practitioners to inform their decision making. They are also a good method of determining the causal relationship between an intervention and its outcomes. They should not, however, be used to replace explanatory studies.
The concept of pragmatism is controversial, and there are questions about whether pragmatic trials should be used to 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, and pragmatic trials that aid in the decision-making process for policy and practice. They also proposed an approach to pragmatic trials, dubbed PRECIS.2 This tool was designed to define the characteristics of a practical trial, including the recruitment process, the design and delivery of the intervention, as well as follow-up.
The number of pragmatic trials is growing. A recent Medline query that used the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs), returned 34 articles. They are displayed in red on Figure 2. This is an indication that the health science community is becoming more acquaint to the subject of pragmatics. However, it is important to keep in mind that the majority of these trials were conducted in primary care settings.