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Studies designed to provide insight into clinical practice in the real world are referred to as pragmatic trials. They are often characterized by a focus on the practical aspects of the study design, such as the recruitment and consent process as well as adherence to the use of commonly available equipment.

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A pragmatic study that involves a variety investigators and includes participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This type of heterogeneity, which is vital for a pragmatic trial to be reliable and lessen the chance of bias is also essential. Too much heterogeneity, however, can cause problems with the trial design.

Pragmatic Play, one of the biggest players on the live casino market, offers various classic table games like Blackjack and Roulette. The live studios of the company in Romania and Malta provide a genuine gaming experience for its customers, as well as an extensive selection of virtual betting options. The company also offers a variety of games which make online gambling fun and interactive. Some of these shows are broadcast live and some include famous people from the field.

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Pragmatic Play offers not only mobile-friendly slot machines, but also table games and live casino. The company is licensed by a variety of regulatory bodies such as Malta Gaming Authority and UK Gambling Commission. The games of the company are secured with high-end encryption and its security team is on hand to help players with any issues.

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The purpose of pragmatic trials is to replicate real-life scenarios and to achieve the highest level of validity externally. They are usually ordered by policymakers and practitioners to help inform their decisions. They can be used to determine the causality of an intervention with its outcomes. They should not, however be used to replace explanatory studies.

The pragmatism concept is controversial and there are concerns about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 proposed a distinction between explanatory studies, which support the physiological hypothesis or clinical hypothesis, as well as pragmatic trials that aid in the practice and policy decision-making. They also proposed an approach to pragmatic trials, dubbed PRECIS.2 This tool was designed to define the features of a practical trial which includes the recruitment process, the design and implementation of the intervention, and follow-up.

There is a positive increase in the number pragmatic trials published. A recent Medline search using the terms pragmatic and naturalistic, restricted to controlled trials randomized to control (RCTs) produced 34 articles, as shown in red in Figure 2. This is an indication that the health sciences community is becoming increasingly sensitized to the subject of pragmatics. It is important to remember that the majority of these studies were conducted in primary care settings.