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Pragmatic trials are those that are designed to inform the real-world practice of clinical. They are typically focused on practical aspects of the research design, like the recruitment and consent process in adherence, as well as the use of commonly available equipment.

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Pragmatic is a software company that offers a wide range of casino games for online gambling platforms. Pragmatic's iGaming software is used by the top operators as well as land-based casinos. The company offers front-end tools for design, analysis, promotions, marketing and payment systems, as well as security, customer service and bug reporting. Additionally, the company provides its players a safe and secure environment with high-quality graphics and games.

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Another example of a practical trial is the Home Blood Pressure Management (HBPM) study, which employed different investigators and had participants from different geographical regions. This kind of heterogeneity is essential for practical trials to be valid and helps to reduce the chance of bias in the results. However too much heterogeneity could lead to issues with the design of the trial.

Pragmatic Play is also a major player in the live casino market, providing an array of classic table games such as Blackjack and Roulette in various versions. The live studios of the company in Romania and Malta offer an authentic gaming experience for its customers and offer a full suite of virtual betting options. The company also has several game shows that make online gambling more exciting and interactive. Some of these shows are telecast live, while others feature famous personalities in the industry.

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Pragmatic Play has earned a name for itself by providing high-quality games and a superior user experience. Its software can be used on mobile devices and in a variety of languages. Despite its infancy it has established itself as a leading gaming platform for casinos. Wolves is one of its latest releases that is a 5-reel slot machine with a healthy RTP and impressive graphics. Other notable games include Wolf Gold and Chilli Heat.

The purpose of pragmatic trials is to simulate real-life scenarios and to achieve maximum validity externally. They are usually requested by policy makers and practitioners to inform their decision making. They can also be used to assess the causality of an intervention with its outcomes. However, they shouldn't be used in lieu for explanation studies.

The pragmatism concept is controversial, and there are questions about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which confirm a physiological or clinical hypothesis, and pragmatic trials that inform the practice and policy decisions. They also proposed a framework for pragmatic trials, called PRECIS.2 This tool attempted to define the characteristics of a pragmatic trial, including the recruitment process, the design and delivery of the intervention, and follow-up.

There is a positive increase in the number of pragmatic trials that are published. A recent Medline query using the keywords pragmatic and naturalistic, limited to randomised controlled trials (RCTs) returned 34 articles. They are displayed in red on Figure 2. This indicates that the health sciences community is becoming more aware of the importance of pragmatism. However, it is important to remember that the majority of these trials were conducted in primary care settings.