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Studies designed to provide insight into clinical practice in the real world are referred to as pragmatic trials. They are often characterized by a focus on practical aspects of the study design, including the recruitment and consent process, adherence, and the use of commonly 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 included participants from various geographical areas. This kind of heterogeneity is essential for pragmatic trials to be able to prove their validity and also helps to reduce bias in the results. However, too much heterogeneity can result in problems with the trial design.
Pragmatic Play is also a major player in the live casino market, offering an extensive selection of classic table games such as Blackjack and Roulette in various versions. The live studios of Pragmatic Play's offices in Romania and Malta provide customers with an authentic gambling experience, and a wide selection of virtual betting options. The company also has several games that make online gambling fun and interactive. Some of these shows feature a live host, while others are hosted by prominent personalities from the industry.
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The aim of pragmatic trials is to simulate real-life scenarios and gain maximum validity externally. They are usually commissioned by policy makers and practitioners to inform their decision making. They can also be used to assess the cause-effect relationship of an intervention and its results. However, they should not be used to replace explanation studies.
The idea of pragmatism is controversial and there are doubts about whether pragmatic trials can replace tests for explanations or if they are an alternative to them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which validate the validity of a clinical or physiological hypothesis and pragmatic trials, which guide the policy and practice of. They also proposed the framework for pragmatic trials, called PRECIS.2 This tool sought to define the characteristics of a practical trial, including recruitment, design and delivery of the intervention, as well as monitoring.
There is an encouraging increase in the number of pragmatic trials that are published. A recent Medline search using the keywords naturalistic and pragmatic, which was limited to controlled trials that are randomized (RCTs) resulted in 34 articles, shown in red in Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatic thinking. However, it is important to note that the majority of these studies were conducted in primary care settings.