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Pragmatic trials are studies designed to provide information for real-world clinical practice. They are typically described as focusing on practical aspects of design that include the recruitment and consent process, as well as adherence and the use of standard equipment.

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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which employed different investigators and participants from different geographic areas. This type of heterogeneity is necessary for pragmatic trials to be able to prove their validity, and it also reduces the chance of bias in the results. A high degree of heterogeneity, however, can cause problems with the trial design.

Pragmatic Play, a major player on the live casino market, provides an array of traditional table games, including Blackjack and Roulette. The live studios of Pragmatic Play's offices in Romania and Malta offer customers an authentic gambling experience, as well a full variety of betting options via virtual. The company also has created various interactive games to make online gambling enjoyable. Some of these shows feature live hosts, while others are hosted by prominent personalities from the industry.

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Legality

Pragmatic Play has earned a name for itself by providing top-quality games and an outstanding user experience. The software is available on mobile devices and in a variety of languages. Despite its relatively young age, it has already established itself as a premier gaming platform for casinos. The most recent releases include Wolves, a 5-reel video slot that has a healthy RTP and impressive graphics. The other notable titles include Wolf Gold and Chilli Heat.

The purpose of pragmatic trials is to simulate real-life scenarios and gain maximum credibility externally. They are usually commissioned by policymakers and practitioners to inform 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 trials.

The concept of pragmatism is controversial, and there are questions 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 a distinction between explanatory trials, which prove the validity of a clinical or physiological hypothesis as well as pragmatic trials, which inform policy and practice decisions. They also suggested a framework for pragmatic trials, which they called PRECIS.2 This tool attempted to define the characteristics of a pragmatic trial which includes the recruitment process, the design and implementation of the intervention, as well as the follow-up.

The number of pragmatic trials is increasing. 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 indicates that the health sciences community has become more aware of the importance of pragmatic thinking. It is important to note, however, that the majority of these studies were conducted in primary-care settings.