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Studies designed to provide insight into clinical practice in the real world are known as pragmatic trials. They are usually focused on the practical aspects of research design, like recruitment and consent, adherence, and the use of commonly available equipment.

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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which utilized a variety of investigators and had participants from different geographic areas. This kind of heterogeneity is necessary for pragmatic trials to be able to prove their validity, and it also reduces the chance of bias in the results. A high degree of heterogeneity, however could cause issues with the trial design.

Pragmatic Play is one of the major players in the live casino market, provides various classic table games like Blackjack and Roulette. The live studios of Pragmatic Play's offices in Romania and Malta provide customers with an authentic gaming experience as well a full variety of betting options via virtual. The company also has several games which make online gambling fun and interactive. Some of these shows feature live hosts, whereas others are hosted by famous personalities from the industry.

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Pragmatic trials seek to replicate real-life settings and achieve maximum external validity. They are typically commissioned by policy makers and practitioners to guide their decision-making. They can also be used to assess the causal relationship between an intervention with its outcomes. However, they shouldn't be used as a substitute for explanatory trials.

The idea of pragmatism is controversial and there are doubts about whether pragmatic trials should replace explanatory tests or if they are an addition to them. Schwartz and Lellouch1 proposed a distinction between explanatory studies, which confirm the validity of a physiological or clinical hypothesis, and pragmatic trials, which inform policy and practice decision-making. They also proposed a framework called PRECIS for pragmatic trials.2 The tool was designed to define the characteristics of a pragmatic study which includes recruitment, design, delivery of the intervention and follow-up.

There is a positive increase in the number pragmatic trials published. A recent Medline search using the words pragmatic and naturalistic, which was restricted to randomised controlled trials (RCTs) returned 34 articles. These are highlighted in red on Figure 2. This indicates that the health science community is becoming more sensitive to the subject of pragmatism. However, it is important to keep in mind that the majority of these trials were conducted in primary care settings.