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Clinical trials that are designed to help inform practice in the real world are called pragmatic trials. They are often characterized by their focus on practical aspects of study design that include recruitment and consent, adherence and the use of routinely available equipment.

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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which used various investigators and had participants from different geographic areas. This type of heterogeneity that is crucial for pragmatic trials to be reliable and to reduce bias in the results is also essential. However, too much heterogeneity can result in problems with the design of the trial.

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Pragmatic Play has earned a reputation for providing top-notch games and an exceptional user experience. The software is available on mobile devices and in multiple languages. It has established itself as one of the most popular gaming platforms in the casino industry despite its relatively young age. The most recent releases include Wolves, a 5-reel video slot that has a healthy RTP and stunning graphics. The other notable titles include Wolf Gold and Chilli Heat.

Pragmatic trials aim to mimic real-life situations and attain maximum external validity. They are typically ordered by policymakers and practitioners to guide their decisions. They can also be a great way to identify the causal relationship between an intervention and its outcomes. However, they shouldn't be used in lieu for explanatory trials.

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 suggested the distinction between explanatory trials, which confirm the clinical or physiological hypothesis as well as pragmatic trials that inform the practice and policy decisions. They also suggested a framework for pragmatic trials, which they called PRECIS.2 This tool attempted to define the features of a pragmatic study that include the recruitment process, the design and delivery of the intervention, and follow-up.

There is a positive increase in the number pragmatic trials published. A recent Medline search using the keywords pragmatic and naturalistic, restricted to controlled trials randomized to control (RCTs) resulted in 34 articles, which are shown in red in Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatic thinking. It is important to remember that the majority of these trials were conducted in primary care settings.

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