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Trials designed to inform clinical practice in the real world are called pragmatic trials. They are often focused on the practical aspects of the study design, such as recruitment and consent as well as adherence to the use of commonly available equipment.

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Another example of a pragmatic trial is the Home Blood Pressure Management (HBPM) study, which used various investigators and included participants from various geographical areas. This kind of heterogeneity is required for pragmatic trials to be valid and reduces the chance of bias in the results. However, too much heterogeneity can result in problems with the trial design.

Pragmatic Play Pragmatic Play, a major player on the live casino market offers a variety of classic table games, including Blackjack and Roulette. The live studios of the company in Romania and Malta offer customers an authentic experience in gambling as well a full selection of virtual betting options. The company also has several games that make online gambling more enjoyable and engaging. Some of these shows feature live hosts, while others are hosted by famous personalities from the industry.

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In addition to their mobile-friendly slot machines, Pragmatic Play also offers tables games and live dealer casinos. Pragmatic Play is licensed and is regulated by various regulatory bodies that include the Malta Gaming Authority and UK Gambling Commission. The games of the company are protected by high-end encryption and its security team is on hand to assist players in any situation.

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Pragmatic Play is renowned for its top-notch games, and for offering an exceptional user experience. The software is available on mobile devices and in multiple languages. It has earned itself the status of one of the top gaming platforms for casinos despite its relatively young age. Wolves is one of its latest releases, a 5-reel slot machine that has a high RTP and impressive graphics. The other notable titles include Wolf Gold and Chilli Heat.

The goal of pragmatic trials is to simulate real-life situations and achieve maximum validity externally. They are typically ordered by policymakers and practitioners to inform their decisions. They can also be a great method to determine the cause-effect relationship between an intervention and its results. However, they should not be used to substitute for the use of explanation trials.

The concept of pragmatism is controversial and there are doubts about whether pragmatic trials should replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which confirm the clinical or physiological hypothesis, and pragmatic trials that inform policy and practice decisions. They also proposed an approach to pragmatic trials, dubbed PRECIS.2 This tool attempted to define the characteristics of a practical trial, including the recruitment process, the design and implementation of the intervention, as well as follow-up.

The number of pragmatic trials is increasing. A recent Medline search using the keywords naturalistic and pragmatic, which was limited to controlled trials that are randomized (RCTs) resulted in 34 articles, shown in red in Figure 2. This is a sign that the health science community is becoming more acquaint to the subject of pragmatic thinking. It is important to note that the majority of these studies were conducted in primary care settings.