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Pragmatic trials are studies designed to inform the practice of clinical trials in real life. They are typically focused on the practical aspects of study design, including the recruitment process and consent as well as adherence to the use of routinely available equipment.
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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which used different investigators and had participants from different geographical regions. This type of heterogeneity that is crucial for pragmatic trials to be reliable and to reduce bias in the results is also essential. However, too much heterogeneity can cause issues with the design of the trial.
Pragmatic Play Pragmatic Play, one of the major players in the live casino market, provides an array of traditional table games, including Blackjack and Roulette. The live studios of the company in Romania and Malta provide customers with an authentic gambling experience, as well a full range of virtual betting options. The company also has created several interactive game shows to make online gambling fun. Some of these shows feature live hosts, while others are hosted by famous personalities from the industry.
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The goal of pragmatic trials is to replicate real-life scenarios and to achieve the highest level of validity externally. Usually, they are ordered by policymakers and practitioners in order to inform their decisions. They can be used to determine the causality of an intervention with its outcomes. They should not, however, be used to replace explanatory studies.
The concept of pragmatism 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 the validity of a clinical or physiological hypothesis and pragmatic trials, which inform the policy and practice of. They also suggested a framework dubbed PRECIS for pragmatic trials.2 The tool was designed to define the traits of a pragmatic research study which includes recruitment, design, implementation of the intervention and its follow-up.
The number of pragmatic trials is growing. A recent Medline query that used the words naturalistic and pragmatic, restricted to randomised controlled trials (RCTs), returned 34 articles. These are shown in red on 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 trials were conducted in primary care settings.