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Pragmatic trials are those that are designed to provide information for the practice of clinical trials in real life. They are often characterized by their focus on practical aspects of design, including recruitment and consent, adherence and the use of standard equipment.

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Another example of a pragmatic trial is the Home Blood Pressure Management (HBPM) study, which utilized various investigators and included participants from different geographical regions. This type of heterogeneity which is vital 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.

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Pragmatic Play has gained a reputation for offering top-notch games and an exceptional user experience. Its software is designed to work with mobile devices and supports different languages. Despite its relative youth it has already established itself as a top gaming platform for casinos. Wolves is one of its latest releases that is a 5-reel slot machine with a healthy RTP and stunning graphics. Other notable titles include Wolf Gold and Chilli Heat.

The aim of pragmatic trials is to replicate real-life scenarios and to achieve maximum validity externally. They are usually requested by practitioners and policymakers to inform their decisions. They can also be a great method of determining the causality between the intervention and its effects. However, they should not be used as a substitute for explanation studies.

The pragmatism idea is controversial, and there are doubts about whether pragmatic trials should replace explanatory trials or complement them. Schwartz and Lellouch1 suggested a distinction between explanatory trials, which confirm a physiological or clinical hypothesis as well as pragmatic trials, which guide policy and practice decisions. 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 follow-up.

There is a positive trend in the number of pragmatic trials that have been published. A recent Medline query that used the words pragmatic and naturalistic, which was restricted to randomised controlled trials (RCTs), returned 34 articles. They are displayed 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 note that the majority of studies were conducted in primary care settings.