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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 typically characterized by a focus on practical aspects of the research design, like the recruitment and consent process in adherence, as well as the use of standard equipment.

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A pragmatic study that involves different investigators and participants from various geographical regions is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is essential for pragmatic trials to be able to prove their validity and also helps to reduce bias in the results. However too much heterogeneity could cause issues with the design of the trial.

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Legality

Pragmatic Play has earned a name for itself by providing high-quality games and a superior user experience. Its software is designed to work with mobile devices and supports different languages. It has earned itself the status of one of the most popular gaming platforms for casinos despite its relatively young age. Wolves is one of the latest games which is a five-reel slot machine with a hefty RTP and impressive graphics. Other notable games include Wolf Gold and Chilli Heat.

The aim of pragmatic trials is to mimic real-life situations and achieve maximum credibility externally. They are typically commissioned by policy makers and practitioners to inform their decision making. They can also be used to assess the cause-effect relationship of an intervention and its effects. However, they should not be used to substitute for explanation studies.

The pragmatism concept is controversial and there are questions 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 the practice and policy decisions. They also suggested a framework for pragmatic trials, called PRECIS.2 This tool was designed to define the characteristics of a practical trial which includes the recruitment process, the design and delivery of the intervention, and the follow-up.

There is an encouraging increase in the number of pragmatic trials that are published. A recent Medline search using the keywords naturalistic and pragmatic, which was limited to controlled trials that are randomized (RCTs) resulted in 34 articles, shown in red in Figure 2. This indicates that the health sciences community is becoming increasingly sensitized to the subject of pragmatism. It is important to keep in mind that the majority of these studies were conducted in primary-care settings.