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Pragmatic trials are those that are designed to inform the practice of clinical trials in real life. They are typically described by their focus on practical aspects of study design which include the recruitment process and consent, adhering and the use of standard equipment.

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A pragmatic study that involves different investigators and participants from various geographical regions is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity, which is vital for a pragmatic trial to be reliable and lessen the chance of bias is also essential. However excessive heterogeneity could result in issues with the design of the trial.

Pragmatic Play Pragmatic Play, a major player on the live casino market, offers an array of traditional table games like Blackjack and Roulette. Pragmatic Play's live studios in Romania and Malta offer a real-life gaming experience for its customers, as well as a full suite of virtual betting options. The company also offers a variety of game shows that make online gambling enjoyable and engaging. Some of these shows are telecast live, while others are hosted by famous personalities from the field.

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Pragmatic Play is known for its top-quality games and for providing a superior user experience. Its software is designed to work on mobile devices and is compatible with various languages. Despite its infancy it has established itself as a leading gaming platform for casinos. Wolves is one of its latest releases that is a 5-reel slot machine with a hefty RTP and impressive graphics. The other notable titles include Wolf Gold and Chilli Heat.

Pragmatic trials seek to replicate real-life situations and attain maximum external validity. They are typically ordered by policymakers and practitioners to inform their decisions. They also provide a useful method to determine the causality between the intervention and its effects. However, they should not be used in lieu for explanation studies.

The concept of pragmatism is controversial, and there are doubts about whether pragmatic trials should replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which prove a physiological or clinical hypothesis as well as pragmatic trials, which guide the practice and policy decisions. They also proposed an approach to pragmatic trials, which they called PRECIS.2 This tool attempted to define the elements of a pragmatic study which includes the recruitment process, the design and delivery of the intervention, and follow-up.

There is a positive increase in the number pragmatic trials that are published. A recent Medline search using the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs), returned 34 articles. These are highlighted in red on Figure 2. This is an indication that the health science community is becoming more sensitive to the subject of pragmatic thinking. It is important to remember, however, that the majority were conducted in primary-care settings.