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Trials designed to inform clinical practice in the real world are called pragmatic trials. They are often described by their focus on practical aspects of designing a study that include the recruitment and consent process, as well as adherence and the use of standard equipment.
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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which utilized different investigators and participants from different geographical regions. This type of heterogeneity, which is vital for a pragmatic trial to be reliable and lessen the chance of bias, is also necessary. However excessive heterogeneity could cause problems with the design of the trial.
Pragmatic Play is also a major player on the live casino market, offering an array of table games that are classic such as Blackjack and Roulette in a variety of versions. The live studios of Pragmatic Play's offices in Romania and Malta offer customers an authentic gambling experience, as well as a broad selection of virtual betting options. The company has also created several interactive game shows to make online gambling enjoyable. Some of these shows feature live hosts, whereas others are hosted by celebrities from the industry.
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Pragmatic Play is renowned for its top-notch games, and for offering an exceptional user experience. Its software can be used on mobile devices as well as in various languages. Despite its infancy it has already established itself as a leading casino gaming platform. Wolves is one of its latest releases that is a 5-reel slot machine with a hefty RTP and stunning graphics. Other notable titles include Wolf Gold and Chilli Heat.
The aim of pragmatic trials is to mimic real-life scenarios and to achieve maximum validity externally. They are usually commissioned by policy makers and practitioners to inform their decision making. They also provide a useful way to identify the causal relationship between an intervention and its results. However, they should not be used in lieu for explanation studies.
The concept of pragmatism is controversial, and there are concerns about whether pragmatic trials should replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanation studies, which confirm the validity of a physiological or clinical hypothesis, and pragmatic trials that aid in the decision-making process for policy and practice. They also proposed a framework for pragmatic trials, called PRECIS.2 This tool was designed to define the features of a pragmatic trial which includes recruitment, design and delivery of the intervention, as well as the follow-up.
The number of pragmatic trials is growing. A recent Medline search using the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs), returned 34 articles. These are highlighted in red on 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 keep in mind, however, that the majority were conducted in primary-care settings.