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Clinical trials that are designed to help inform practice in the real world are known as pragmatic trials. They are often characterized by a focus on the practical aspects of the study design, including recruitment and consent as well as adherence to the use of standard equipment.

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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which employed a variety of investigators and participants from different geographic areas. This kind of heterogeneity is essential for practical trials to be valid and reduces bias in the results. A high degree of heterogeneity, however, can cause problems with the trial design.

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Pragmatic Play offers not only mobile-friendly slot machines but also table games and live casino. The company is licensed and regulated by several governing bodies which include the Malta Gaming Authority and UK Gambling Commission. The company's games are secured by top-of-the-line encryption and its security staff is available to assist players in any situation.

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Pragmatic Play is known for its top-quality games and for offering an exceptional user experience. Its software is designed to work with mobile devices and supports multiple languages. It has established itself as one of the most popular casino gaming platforms despite its relative infancy. Wolves is one of the latest games which is a five-reel slot machine with a healthy RTP and stunning graphics. Other notable games include Wolf Gold and Chilli Heat.

The purpose of pragmatic trials is to simulate real-life scenarios and gain the highest level of validity externally. They are typically requested by practitioners and policymakers in order to guide their decisions. They are also a good method of determining the causal relationship between the intervention and its effects. They should, however, not be used to replace explanation studies.

The idea of pragmatism is controversial, and there are questions about whether pragmatic trials can replace tests for explanations or if they are a complement to them. Schwartz and Lellouch1 proposed an distinction between explanation-based studies, which prove the validity of a physiological or clinical hypothesis, as well as pragmatic trials, which inform the practice and policy decision-making. They also proposed the framework for pragmatic trials, which they called PRECIS.2 This tool sought to define the characteristics of a pragmatic trial, including recruitment, design and delivery of the intervention, as well as follow-up.

The number of pragmatic trials is growing. A recent Medline query that used the words pragmatic and naturalistic, which was restricted to randomised controlled trials (RCTs) returned 34 articles. These are shown in red on Figure 2. This suggests that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to remember, however, that the majority were conducted in primary-care settings.