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Clinical trials that are designed to help inform practice in the real world are referred to as pragmatic trials. They are often characterized by a focus on the practical aspects of study design, such as the recruitment process and consent as well as adherence to the use of standard equipment.

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Pragmatic, a software company, offers a variety of casino games for online gambling platforms. Its iGaming software is used by the top operators as well as casinos that are located in the land. The company offers front-end website design tools, analysis and promotions, marketing security, payment systems, customer support and bug-reporting. Additionally, the company offers its players a safe and secure environment with high-quality graphics as well as gameplay.

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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which utilized various investigators and included participants from different geographical regions. This kind of heterogeneity is required for practical trials to be valid and helps reduce the chance of bias in the results. A high degree of heterogeneity, however can result in problems with the trial design.

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Legality

Pragmatic Play is known for its top-notch games, and for offering an exceptional user experience. Its software is designed to work on mobile devices and is compatible with multiple languages. It has been recognized as one of the leading casino gaming platforms despite its relatively young age. Wolves is one of the latest games which is a five-reel slot machine with a hefty RTP and stunning graphics. The other notable titles include Wolf Gold and Chilli Heat.

Pragmatic trials aim to mimic real-world situations and have the highest external validity. Usually, they are commissioned by policymakers and practitioners in order to inform their decisions. They can also be used to assess the cause-effect relationship of an intervention with its outcomes. However, they shouldn't be used as a substitute for explanation studies.

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

There is a positive trend in the number of pragmatic trials published. A recent Medline search using the keywords pragmatic and naturalistic, restricted to randomized controlled trials (RCTs) resulted in 34 articles, shown in red in Figure 2. This indicates that the health sciences community has become more aware of the importance of pragmatic thinking. It is important to note, however, that the majority were conducted in primary care settings.