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Pragmatic trials are trials designed to inform the practice of clinical trials in real life. They are often focused on the practical aspects of research design, like recruitment and consent, adherence, and the use of commonly available equipment.

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Pragmatic Software, a software firm offers a range of casino games to online gambling platforms. Pragmatic's iGaming software is used by leading operators and land based casinos. The company offers front-end site design tools, analysis and marketing, promotions, security, payment systems, customer service and bug reporting. The company also offers security, high-quality graphics, gaming and security.

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A practical trial that employs various investigators and participants from various geographical regions is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is required for pragmatic trials to be able to prove their validity and reduces the chance of bias in the results. However, too much heterogeneity, can cause problems with the design of the trial.

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Pragmatic Play has earned a reputation for providing high-quality games and a superior user experience. Its software is designed to work on mobile devices and is compatible with different languages. Despite its relative youth it has established itself as a top gaming platform for casinos. Wolves is one of the latest games which is a five-reel slot machine with a healthy RTP and impressive graphics. Its other notable titles are Wolf Gold and Chilli Heat.

Pragmatic trials aim to mimic real-life situations and attain maximum external validity. They are usually requested by practitioners and policy makers to inform their decision making. They are also a good way to identify the cause-effect relationship between the intervention and its effects. However, they should not be used as a substitute for explanatory trials.

The pragmatism idea is controversial and there are doubts regarding whether pragmatic trials could replace explanatory tests or if they should be an addition to them. Schwartz and Lellouch1 suggested an distinction between explanation-based studies, which prove a physiological hypothesis or clinical hypothesis, and pragmatic trials, that inform policy and practice decision-making. They also suggested a framework dubbed PRECIS for pragmatic trials.2 The tool was designed to define the characteristics of a pragmatic study, including the recruitment, design, and delivery of the intervention, and follow-up.

There is an encouraging increase in the number of pragmatic trials that have been published. A recent Medline search using the words naturalistic and pragmatic, restricted to randomised controlled trials (RCTs), returned 34 articles. These are shown in red on Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatic thinking. It is important to note that the majority of studies were conducted in primary-care settings.