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Trials designed to inform clinical practice in the real world are called pragmatic trials. They are typically described as a focus on the practical aspects of design, including the recruitment process and consent, adhering and the use routinely available equipment.

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

Pragmatic Play is one of the major players in the live casino market offers a variety of classic table games such as Blackjack and Roulette. Pragmatic Play's live studios in Romania and Malta provide a genuine gambling experience for players and offer a full suite of virtual betting options. The company also has created numerous interactive game shows that make gambling online enjoyable. Some of these shows have live hosts, while others are hosted by famous personalities from the industry.

Mobile compatibility

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Pragmatic Play offers not only mobile-friendly slot machines but also table games and live casino. The company is licensed and regulated by a variety of regulatory bodies that include the Malta Gaming Authority and UK Gambling Commission. The games are supported by the latest encryption technology and the security team is always on hand to help players resolve any issues they might have.

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Legality

Pragmatic Play has earned a name for itself by providing top-quality games and an outstanding user experience. Its software can be used on mobile devices as well as in various languages. It has earned itself the status of one of the top gaming platforms for casinos despite its relative youth. Its latest releases include Wolves which is a five-reel video slot with a healthy RTP and impressive graphics. The other notable titles include Wolf Gold and Chilli Heat.

Pragmatic trials are designed to replicate real-life situations and attain maximum external validity. They are usually requested by practitioners and policy makers to guide their decision-making. They also provide a useful way to identify the cause-effect relationship between an intervention and its results. However, they should not be used as a substitute for explanatory studies.

The pragmatism idea is controversial and there are doubts about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which prove the clinical or physiological hypothesis, and pragmatic trials, which inform the practice and policy decisions. They also suggested an approach to pragmatic trials, which they called PRECIS.2 This tool sought to define the elements of a pragmatic trial, including the recruitment process, the design and delivery of the intervention, as well as follow-up.

There is a growing increase in the number of pragmatic trials that are published. A recent Medline search using the terms naturalistic and pragmatic, limited to controlled trials randomized to control (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. It is important to remember that the majority were conducted in primary care settings.