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Studies designed to provide insight into clinical practice in the real world are called pragmatic trials. They are typically focused on the practical aspects of the study design, including the recruitment and consent process in adherence, as well as 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 employed various investigators and participants from different geographic areas. This type of heterogeneity is essential for practical trials to be valid, and it also helps to reduce the chance of bias in the results. However, too much heterogeneity can result in problems with the design of the trial.
Pragmatic Play Pragmatic Play, one of the biggest players on the live casino market, provides an array of traditional table games such as Blackjack and Roulette. The live studios of Pragmatic Play's offices in Romania and Malta offer customers an authentic experience in gambling as well as a broad range of virtual betting options. The company also offers a variety of games that make online gambling more exciting and interactive. Some of these shows feature live hosts, while others are hosted by celebrities from the industry.
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The purpose of pragmatic trials is to mimic real-life scenarios and to achieve maximum validity externally. Usually, they are requested by practitioners and policymakers in order to guide their decisions. They can also be a great way to identify the cause-effect relationship between the intervention and its effects. However, they should not be used in lieu for the use of explanation studies.
The idea of pragmatism is controversial and there are concerns about whether pragmatic trials should replace tests for explanations or if they are a complement to them. Schwartz and Lellouch1 made a distinction between explanatory studies, which prove the physiological hypothesis or clinical hypothesis, and pragmatic trials, that inform the decision-making process for policy and practice. They also suggested a framework for pragmatic trials, which they called PRECIS.2 This tool was designed to define the features of a pragmatic study, including the recruitment process, the design and implementation of the intervention, as well as monitoring.
There is a growing increase in the number pragmatic trials that are published. A recent Medline query using the keywords pragmatic and naturalistic, limited to randomised controlled trials (RCTs) returned 34 articles. These are shown in red on Figure 2. This suggests that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to remember that the majority of these studies were conducted in primary care settings.