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Trials designed to inform clinical practice in the real world are referred to as pragmatic trials. They are typically focused on the practical aspects of the research design, like the recruitment and consent process in adherence, as well as the use of routinely available equipment.
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A pragmatic trial that uses various investigators and participants from various geographical regions is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity, that is crucial for a pragmatic trial to be reliable and reduce bias in results is also essential. However, too much heterogeneity can lead to problems with the design of the trial.
Pragmatic Play, one of the biggest players on the live casino market, provides an array of traditional table games such as Blackjack and Roulette. The live studios of Pragmatic Play in Romania and Malta provide customers with an authentic experience in gambling as well a full range of virtual betting options. The company has also created numerous interactive game shows that make online gambling fun. Some of these shows are telecast live and some are hosted by famous personalities from the field.
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Legality
Pragmatic Play is known for its top-notch games, and for offering an exceptional user experience. Its software is designed to work on mobile devices and supports various languages. Despite its relative youth it has established itself as a top gaming platform for casinos. Wolves is one of its latest releases, a 5-reel slot machine with a healthy RTP and stunning graphics. Other notable titles include Wolf Gold and Chilli Heat.
The aim of pragmatic trials is to replicate real-life situations and achieve the highest level of validity externally. They are typically commissioned by policymakers and practitioners to guide their decisions. They can be used to determine the cause-effect relationship of an intervention and its results. They should not, however, be used to replace explanatory studies.
The idea of pragmatism is controversial and there are doubts about whether pragmatic trials can replace explanatory tests or if they are a complement to them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which confirm a physiological or clinical hypothesis, and pragmatic trials that inform policy and practice decisions. They also proposed a framework for pragmatic trials, dubbed PRECIS.2 This tool sought to define the elements of a practical trial that include the recruitment process, the design and implementation of the intervention, and the follow-up.
There is a growing increase in the number of pragmatic trials that have been published. A recent Medline search using the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs), returned 34 articles. These are shown in red on Figure 2. This indicates that the health sciences community has become more aware of the importance of pragmatic thinking. However, it is important to keep in mind that the majority of these studies were conducted in primary care settings.