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Clinical trials that are designed to help inform practice in the real world are called pragmatic trials. They are often focused on practical aspects of the research design, like recruitment and consent in adherence, as well as the use of commonly available equipment.
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A pragmatic trial that uses a variety investigators and includes participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This type of heterogeneity which is essential for a pragmatic trial to be reliable and reduce bias in results, is also necessary. However, too much heterogeneity can result in problems with the trial design.
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Mobile compatibility
Pragmatic Play, a new player in the field of online casinos, has gained a reputation for its mobile-friendly slot machines. Their games are optimized for mobile phones, and run on HTML5 technology. They are also certified and regulated by respected gaming authorities, ensuring fairness and transparency. This is a positive indication for players as it means that the games are tested and verified to ensure that the outcomes of each round are random and fair.
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Legality
Pragmatic Play has earned a reputation for providing high-quality games and a superior user experience. Its software is designed to work on mobile devices and supports multiple languages. It has established itself as one of the leading casino gaming platforms despite its relatively young age. Wolves is one of its latest releases, a 5-reel slot machine with a hefty RTP and impressive graphics. Other notable games include Wolf Gold and Chilli Heat.
Pragmatic trials seek to replicate real-life settings and achieve maximum external validity. They are typically requested by practitioners and policymakers in order to guide their decisions. They can be used to determine the causal relationship between an intervention and its effects. However, they should not, be used to replace the need for explanation studies.
The pragmatism concept is controversial and there are doubts about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 suggested a distinction between explanatory studies, which prove the validity of a physiological or clinical hypothesis, and pragmatic trials, that inform the decision-making process for policy and practice. They also proposed an approach to pragmatic trials, dubbed PRECIS.2 This tool sought to define the elements of a practical trial, including recruitment, design and delivery of the intervention, and monitoring.
There is a positive increase in the number pragmatic trials published. A recent Medline search using the terms pragmatic and naturalistic, restricted to controlled trials randomized to control (RCTs) resulted in 34 articles, which are shown in red in Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatism. However, it is important to keep in mind that the majority of these trials were conducted in primary care settings.