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Clinical trials that are designed to help inform practice in the real world are referred to as pragmatic trials. They are often focused on the practical aspects of the study design, including the recruitment and consent process in adherence, as well as the use of routinely available equipment.

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Pragmatic is a software company offers a range of casino games on online gambling platforms. Pragmatic's iGaming software is used by the top operators and land based casinos. The company provides front-end design tools, analysis tools, marketing, promotions, payment systems, security, customer support and bug reporting. The company also provides a safe environment with high-quality graphics, games and security.

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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 various geographical areas. This type of heterogeneity is required for pragmatic trials to be valid, and it also helps reduce bias in the results. A high degree of heterogeneity, however could cause issues with the trial design.

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Pragmatic trials aim to mimic real-world situations and have the highest external validity. They are usually requested by practitioners and policymakers to help guide their decisions. They also provide a useful method of determining the causality between the intervention and its effects. They should, however, not be used to replace explanatory studies.

The pragmatism idea is controversial and there are concerns regarding whether pragmatic trials could be used to replace explanation tests or if they should serve as a complement to them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which confirm the clinical or physiological hypothesis and pragmatic trials, which inform the policy and practice of. They also suggested a framework known as PRECIS for pragmatic trials.2 This tool tried to define the characteristics of a pragmatic study, including the recruitment, design, and delivery of the intervention, and follow-up.

There is a positive trend in the number of pragmatic trials that have been published. A recent Medline query using the keywords pragmatic and naturalistic, limited to randomised controlled trials (RCTs), returned 34 articles. These are shown in red on Figure 2. This suggests that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to keep in mind that the majority of these studies were conducted in primary-care settings.