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Pragmatic trials are studies designed to provide information for the real-world practice of clinical. They are often characterized by their focus on practical aspects of study design that include recruitment and consent, adherence and the use of standard equipment.
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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which utilized a variety of investigators and participants from different geographical regions. This kind of heterogeneity is required for pragmatic trials to be able to prove their validity and also reduces the chance of bias in the results. However, too much heterogeneity, can 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 and regulated by several authorities which include the Malta Gaming Authority and UK Gambling Commission. The company's games are protected by high-end encryption and its security team is available to assist players with any issues.
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Pragmatic trials seek to replicate real-life situations and attain maximum external validity. They are usually commissioned by policymakers and practitioners to guide their decisions. They can be used to determine the causality of an intervention and its effects. However, they should not be used in lieu for explanation studies.
The concept of pragmatism is controversial and there are concerns about whether pragmatic trials should replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanation studies, which support a physiological hypothesis or clinical hypothesis, and pragmatic trials, that inform policy and practice decision-making. They also suggested the framework for pragmatic trials, dubbed PRECIS.2 This tool was designed to define the characteristics of a practical trial that include the recruitment process, the design and delivery of the intervention, and the follow-up.
The number of pragmatic trials is increasing. A recent Medline search using the keywords naturalistic and pragmatic, limited to randomized controlled trials (RCTs) produced 34 articles, shown in red in Figure 2. This indicates that the health sciences community is becoming increasingly sensitized to the subject of pragmatic thinking. It is important to remember, however, that the majority were conducted in primary-care settings.