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Pragmatic trials are those that are designed to provide information for the practice of clinical trials in real life. They are typically focused on the practical aspects of study design, including recruitment and consent as well as adherence to the use of commonly available equipment.

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

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Legality

Pragmatic Play is known for its top-notch games, and for offering an exceptional user experience. Its software is accessible on mobile devices and in multiple languages. It has earned itself the status of one of the most popular casino gaming platforms despite its relative youth. Its latest releases include Wolves 5 reel video slot with a healthy RTP and impressive graphics. Other notable games include Wolf Gold and Chilli Heat.

Pragmatic trials are designed to replicate real-world situations and have the highest external validity. They are usually commissioned by policy makers and practitioners to guide their decision-making. They also provide a useful method of determining the cause-effect relationship between an intervention and its results. However, they should not be used as a substitute for explanatory studies.

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 made an distinction between explanation-based studies, which support the physiological hypothesis or clinical hypothesis, as well as pragmatic trials, that inform the decision-making process for policy and practice. They also proposed a framework for pragmatic trials, called PRECIS.2 This tool sought to define the characteristics of a pragmatic study that include the recruitment process, the design and implementation of the intervention, as well as follow-up.

There is a growing trend in the number of pragmatic trials that are published. A recent Medline search using the terms naturalistic and pragmatic, which was limited to randomized controlled trials (RCTs) resulted in 34 articles, shown in red in Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatism. However, it is important to keep in mind that the majority of these studies were conducted in primary care settings.