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Trials designed to inform clinical practice in the real world are known as pragmatic trials. They are usually characterized by a focus on practical aspects of the research design, like the recruitment and consent process as well as adherence to the use of routinely available equipment.

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A practical trial that employs a variety investigators and includes participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is necessary for practical trials to be valid and helps to reduce the chance of bias in the results. Too much heterogeneity, however can result in problems with the trial design.

Pragmatic Play is a major player on the live casino market, offers a variety of classic table games such as Blackjack and Roulette. The live studios of the company in Romania and Malta offer a real-life gambling experience for players, as well as a wide range of virtual betting options. The company has also created numerous interactive game shows that make online gambling enjoyable. Some of these shows have live hosts, while others are hosted by prominent personalities from the industry.

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The purpose of pragmatic trials is to replicate real-life scenarios and gain maximum credibility externally. They are usually requested by practitioners and policymakers in order to inform their decisions. They can be used to determine the causality of an intervention and its effects. However, they should not be used to substitute for explanation studies.

The pragmatism idea is controversial and there are doubts regarding whether pragmatic trials could replace explanatory tests or if they should serve as an alternative to them. Schwartz and Lellouch1 suggested a distinction between explanatory trials, which confirm a physiological or clinical hypothesis as well as pragmatic trials that inform policy and practice decisions. They also suggested a framework dubbed PRECIS for pragmatic trials.2 The tool was designed to define the elements of a practical study, including recruitment, design, implementation of the intervention, and follow-up.

There is a positive increase in the number pragmatic trials published. A recent Medline search using the terms naturalistic and pragmatic, which was limited to controlled trials randomized to control (RCTs) produced 34 articles, shown in red in Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatic thinking. It is important to note, however, that the majority of studies were conducted in primary care settings.