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Pragmatic trials are those that are designed to inform the practice of clinical trials in real life. They are typically focused on the practical aspects of the research design, like the recruitment process and consent, adherence, and the use of commonly available equipment.

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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which used different investigators and participants from various geographical areas. This type of heterogeneity which is vital for a pragmatic trial to be valid and to reduce bias in the results, is also necessary. However too much heterogeneity could lead to problems with the design of the trial.

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Pragmatic Play is known for its top-quality games and for offering an exceptional user experience. Its software is designed to work with mobile devices and is compatible with multiple languages. It has established itself as one of the leading gaming platforms in the casino industry despite its relatively young age. The latest releases include Wolves which is a five-reel video slot that has a healthy RTP and impressive graphics. Other notable titles include Wolf Gold and Chilli Heat.

The purpose of pragmatic trials is to replicate real-life scenarios and to achieve maximum validity externally. They are usually requested by practitioners and policy makers to guide their decision-making. They are also a good method to determine the causality between the intervention and its effects. They should not, however be used to replace explanation studies.

The concept of pragmatism is controversial and there are concerns about whether pragmatic trials can replace tests for explanations or if they are an alternative to them. Schwartz and Lellouch1 proposed an distinction between explanation-based studies, which confirm the physiological hypothesis or clinical hypothesis, as well as pragmatic trials that aid in the decision-making process for policy and practice. They also proposed a framework called PRECIS for pragmatic trials.2 This tool tried to define the elements of a pragmatic study, including recruitment, design, delivery of the intervention and its follow-up.

There is an encouraging trend in the number of pragmatic trials that have been published. A recent Medline search using the keywords naturalistic and pragmatic, limited to controlled trials randomized to control (RCTs) produced 34 articles, which are shown in red in Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to remember that the majority of these studies were conducted in primary-care settings.

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