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Trials designed to inform clinical practice in the real world are called pragmatic trials. They are often described by their focus on practical aspects of designing a study which include the recruitment process and consent, adhering and the use routinely available equipment.

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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which utilized various investigators and included participants from different geographical regions. This type of heterogeneity is essential for practical trials to be valid, and it also reduces bias in the results. However too much heterogeneity could result in issues with the design of the trial.

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Legality

Pragmatic Play has earned a reputation for providing top-notch games and an exceptional user experience. Its software is designed to work with mobile devices and is compatible with different languages. Despite its relatively young age it has established itself as a premier casino gaming platform. The latest releases include Wolves, a 5-reel video slot that has a healthy RTP and stunning graphics. Other notable titles include Wolf Gold and Chilli Heat.

The aim of pragmatic trials is to mimic real-life situations and achieve the highest level of validity externally. They are usually commissioned by policy makers and practitioners to guide their decision-making. They can also be a great method of determining the causality between an intervention and its results. However, they should not be used to substitute for the use of explanation trials.

The pragmatism concept is controversial and there are concerns about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which prove a physiological or clinical hypothesis, and pragmatic trials, which guide the practice and policy decisions. They also proposed a framework called PRECIS for pragmatic trials.2 This tool tried to define the characteristics of a pragmatic study which includes recruitment, design, implementation of the intervention, and follow-up.

The number of pragmatic trials is increasing. A recent Medline search using the terms pragmatic and naturalistic, restricted to randomized controlled trials (RCTs), yielded 34 articles, which are shown in red in Figure 2. This suggests that the health sciences community is becoming more aware of the importance of pragmatism. It is important to keep in mind, however, that the majority of these studies were conducted in primary care settings.