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Studies designed to provide insight into clinical practice in the real world are known as pragmatic trials. They are often characterized as a focus on the practical aspects of design, including the recruitment process and consent, adhering and the use routinely available equipment.

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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 participants from different geographical regions. This kind of heterogeneity, that is crucial for pragmatic trials to be reliable and to reduce bias in the results is also essential. However excessive heterogeneity could cause problems with the design of the trial.

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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 several regulatory bodies such as Malta Gaming Authority and UK Gambling Commission. Its games are backed by top-of-the-line encryption technology and the security team is always ready to assist players resolve any issues they might have.

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Legality

Pragmatic Play has earned a name for itself by providing top-quality games and an outstanding user experience. The software is available on mobile devices and in a variety of languages. Despite its relative youth it has already established itself as a top gaming platform for casinos. Its latest releases include Wolves which is a five-reel video slot with a healthy RTP and impressive graphics. Other notable titles include Wolf Gold and Chilli Heat.

The goal of pragmatic trials is to replicate real-life scenarios and to achieve maximum credibility externally. They are usually requested by practitioners and policy makers to aid in their decision-making. They can also be used to assess the cause-effect relationship 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 be used to replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which prove the clinical or physiological hypothesis, and pragmatic trials that inform policy and practice decisions. They also suggested a framework for pragmatic trials, which they called PRECIS.2 This tool attempted to define the elements of a pragmatic study that include the recruitment process, the design and implementation of the intervention, and monitoring.

The number of pragmatic trials is growing. A recent Medline search using the terms naturalistic and pragmatic, limited to controlled trials randomized to control (RCTs), yielded 34 articles, which are shown in red in Figure 2. This is a sign that the health science community is becoming more acquaint to the issue of pragmatic thinking. It is important to remember that the majority of these studies were conducted in primary-care settings.