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Studies designed to provide insight into clinical 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 the recruitment and consent process as well as adherence to the use of routinely available equipment.

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Pragmatic, a software company provides a variety of casino games to online gambling platforms. Pragmatic's iGaming software is used by top operators and land based casinos. The company provides front-end design tools, analysis tools, marketing, promotions and payment systems, as well as security, customer service and bug reporting. The company also provides an environment that is safe and secure with high-quality graphics, gaming and security.

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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which used a variety of investigators and had participants from different geographical regions. This kind of heterogeneity is essential for pragmatic trials to be able to prove their validity and also helps to reduce bias in the results. However too much heterogeneity could result in problems with the design of the trial.

Pragmatic Play is also a major player in the live casino market, offering an extensive selection of table games like as Blackjack and Roulette in a variety of versions. The company's live studios in Romania and Malta provide a genuine 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 fun. Some of these shows have live hosts, while others are hosted by prominent personalities from the industry.

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Pragmatic Play is a new player in the world of online casinos, but it has made a name for itself through its mobile-friendly slot machines. Their games are optimized for mobile devices and run on HTML5 technology. They are also certified by reputable gaming authorities to ensure transparency and fairness. This is a good indication for players as it means that the games are checked and verified to ensure that the results of every round are random and fair.

Pragmatic Play offers not only mobile-friendly slot machines as well as table games and live casino. Pragmatic Play is licensed by various regulatory bodies such as 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 help players with any issues.

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The purpose of pragmatic trials is to replicate real-life scenarios and to achieve maximum credibility externally. They are usually commissioned by practitioners and policy makers to aid in their decision-making. They can also be a great method of determining the causal relationship between an intervention and its outcomes. However, they should not be used as a substitute for the use of explanation studies.

The pragmatism concept is controversial and there are questions about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 proposed an distinction between explanation-based studies, which confirm the validity of a physiological or clinical hypothesis, as well as 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 characteristics of a pragmatic study that include the recruitment process, the design and delivery of the intervention, as well as follow-up.

There is an encouraging increase in the number of pragmatic trials that are published. A recent Medline search using the terms naturalistic and pragmatic, which was limited to randomized controlled trials (RCTs), yielded 34 articles, shown in red in Figure 2. This indicates that the health sciences community is becoming more acquaint to the issue of pragmatism. It is important to note, however, that the majority of these studies were conducted in primary-care settings.