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Studies designed to provide insight into 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 routinely available equipment.

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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which employed various investigators and included participants from different geographic areas. This type of heterogeneity, which is essential for pragmatic trials to be valid and lessen the chance of bias is also essential. However too much heterogeneity could result in issues with the design of the trial.

Pragmatic Play Pragmatic Play, one of the biggest players on the live casino market, provides a variety of classic table games such as Blackjack and Roulette. The company's live studios in Romania and Malta offer a real-life gambling experience for customers and offer a wide range of virtual betting options. The company has also created various interactive games to make gambling online enjoyable. Some of these shows feature live hosts, while others are hosted by prominent personalities from the industry.

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Pragmatic Play has earned a name for itself by providing top-notch games and an exceptional user experience. The software is available on mobile devices as well as in various languages. Despite its relative youth it has established itself as a top casino gaming platform. Wolves is one of the most recent releases which is a five-reel slot machine with a hefty RTP and stunning graphics. Other notable titles include Wolf Gold and Chilli Heat.

Pragmatic trials aim to mimic real-life situations and attain maximum external validity. They are typically commissioned by policymakers and practitioners in order to guide their decisions. They can also be used to determine the cause-effect relationship of an intervention with its outcomes. However, they should not be used to substitute for explanatory trials.

The pragmatism concept is controversial and there are concerns about whether pragmatic trials should replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which confirm a physiological or clinical hypothesis and pragmatic trials, which inform the practice and policy decisions. They also suggested the framework for pragmatic trials, dubbed PRECIS.2 This tool attempted to define the features of a practical trial, including the recruitment process, the design and delivery of the intervention, and the follow-up.

There is a positive increase in the number of pragmatic trials that have been published. A recent Medline query using the keywords 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 increasingly sensitized to the subject of pragmatics. It is important to keep in mind that the majority of these studies were conducted in primary care settings.