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Studies designed to provide insight into clinical practice in the real world are called pragmatic trials. They are often characterized as focusing on practical aspects of designing a study which include the recruitment and consent process, as well as adherence and the use routinely available equipment.

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A practical trial that employs various investigators and participants from different geographical areas 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 essential. However, too much heterogeneity can result in problems with the trial design.

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Pragmatic Play has earned a reputation for providing top-notch games and an exceptional user experience. Its software is accessible on mobile devices as well as in various languages. Despite its relative youth it has already established itself as a leading gaming platform for casinos. The latest releases include Wolves which is a five-reel video slot that has a healthy RTP and stunning graphics. Other notable titles include Wolf Gold and Chilli Heat.

The aim of pragmatic trials is to simulate real-life scenarios and to achieve maximum credibility externally. Usually, they are commissioned by policymakers and practitioners 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. They should not, however, be used to replace explanation studies.

The concept of pragmatism is controversial, and there are questions about whether pragmatic trials can replace tests for explanations or if they should be an addition to them. Schwartz and Lellouch1 proposed the distinction between explanation studies, which confirm the validity of a physiological or clinical hypothesis, and pragmatic trials, that inform the decision-making process for policy and practice. They also proposed a framework for pragmatic trials, dubbed PRECIS.2 This tool sought to define the elements of a practical trial which includes the recruitment process, the design and delivery of the intervention, as well as the follow-up.

The number of pragmatic trials is growing. A recent Medline query using the keywords naturalistic and pragmatic, restricted to randomised controlled trials (RCTs) returned 34 articles. These are highlighted 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 were conducted in primary care settings.