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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 focusing on practical aspects of design, including the recruitment process and consent, adhering and the use of routinely available equipment.

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Pragmatic is a software development company that provides a variety of casino games available on online gambling platforms. Pragmatic's iGaming software is used by the top operators as well as casinos that are located in the land. The company offers front-end website design tools, analysis tools and marketing, promotions security, payment systems, customer support and bug-reporting. The company also provides a safe environment with high-quality graphics, gameplay and security.

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Another example of a pragmatic trial is the Home Blood Pressure Management (HBPM) study, which used a variety of investigators and had participants from various geographical areas. This kind of heterogeneity is essential for pragmatic trials to be able to prove their validity and reduces the chance of bias in the results. However excessive heterogeneity could lead to issues with the design of the trial.

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Pragmatic trials are designed to replicate real-life settings and achieve maximum external validity. They are typically commissioned by policymakers and practitioners in order to inform their decisions. They can also be a great method to determine the cause-effect relationship between the intervention and its effects. However, they should not be used to substitute for the use of explanation trials.

The pragmatism idea is controversial and there are doubts about whether pragmatic trials can replace explanatory tests or if they should be a complement to them. Schwartz and Lellouch1 suggested an distinction between explanation-based studies, which support 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 suggested a framework known as PRECIS for pragmatic trials.2 This tool attempted to define the elements of a pragmatic study which includes recruitment, design, delivery of the intervention and follow-up.

The number of pragmatic trials is increasing. A recent Medline search using the keywords naturalistic and pragmatic, which was limited to randomized controlled trials (RCTs), yielded 34 articles, as shown in red in Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to note, however, that the majority of these studies were conducted in primary-care settings.