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Pragmatic trials are trials designed to inform the practice of clinical trials in real life. They are often characterized by their focus on practical aspects of design that include the recruitment process and consent, adhering and the use of standard equipment.
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A practical trial that employs different investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This type of heterogeneity which is essential for pragmatic trials to be valid and reduce bias in results, is also necessary. However, too much heterogeneity can result in problems with the design of the trial.
Pragmatic Play Pragmatic Play, one of the major players in the live casino market, provides a variety of classic table games such as Blackjack and Roulette. The live studios of the company in Romania and Malta provide customers with an authentic gaming experience as well as a broad selection of virtual betting options. The company also has created numerous interactive game shows that make online gambling fun. Some of these shows feature live hosts, whereas others are hosted by celebrities from the industry.
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Legality
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Pragmatic trials seek to replicate real-world situations and have the highest external validity. They are usually requested by practitioners and policymakers to guide their decisions. They can also be used to assess the causality of an intervention and its effects. However, they should not be used to substitute for explanation studies.
The idea of pragmatism is controversial and there are doubts about whether pragmatic trials can replace tests for explanations or if they should serve as a complement to them. Schwartz and Lellouch1 made an distinction between explanation-based studies, which prove the physiological hypothesis or clinical hypothesis, as well as pragmatic trials, that inform the practice and policy decision-making. They also suggested a framework known as PRECIS for pragmatic trials.2 This tool attempted to define the elements of a practical study, including recruitment, design, delivery of the intervention and its follow-up.
There is a positive trend in the number of pragmatic trials that are published. A recent Medline search using the keywords naturalistic and pragmatic, limited to randomized controlled trials (RCTs) produced 34 articles, which are shown in red in Figure 2. This is an indication that the health sciences community is becoming more sensitive to the subject of pragmatics. However, it is important to remember that the majority of these studies were conducted in primary care settings.