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Clinical trials that are designed to help inform practice in the real world are referred to as pragmatic trials. They are often described as a focus on the practical aspects of design, including the recruitment process and consent, adhering and the use routinely available equipment.

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A pragmatic trial that uses different investigators and participants from different geographical areas is the Home Blood Pressure Management study (HBPM). This type of heterogeneity, which is vital for pragmatic trials to be valid and lessen the chance of bias, is also necessary. A high degree of heterogeneity, however, can cause problems with the trial design.

Pragmatic Play Pragmatic Play, one of the biggest players on the live casino market offers a variety of classic table games like Blackjack and Roulette. The company's live studios in Romania and Malta provide a genuine gambling experience for players, as well as a full suite of virtual betting options. The company has also developed various interactive games to make online gambling fun. Some of these shows are hosted live and some feature famous personalities in the field.

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Pragmatic Play is renowned for its top-quality 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 top gaming platform for casinos. Its latest releases include Wolves, a 5-reel video slot with a healthy RTP and impressive graphics. The other notable titles include Wolf Gold and Chilli Heat.

The goal of pragmatic trials is to simulate real-life scenarios and gain the highest level of validity externally. They are usually commissioned by practitioners and policy makers to guide their decision-making. They can also be used to determine the cause-effect relationship of an intervention and its effects. However, they shouldn't be used as a substitute for explanatory trials.

The pragmatism idea is controversial and there are doubts about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 suggested a distinction between explanatory trials, which prove the clinical or physiological hypothesis as well as pragmatic trials that inform the practice and policy decisions. They also suggested a framework dubbed PRECIS for pragmatic trials.2 The tool was designed to define the characteristics of a pragmatic research study, including recruitment, design, implementation of the intervention, and follow-up.

The number of pragmatic trials is growing. A recent Medline search using the terms naturalistic and pragmatic, limited to controlled trials that are randomized (RCTs) resulted in 34 articles, as shown in red in Figure 2. This suggests that the health sciences community is becoming more aware of the importance of pragmatism. It is important to remember, however, that the majority were conducted in primary-care settings.