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Studies designed to provide insight into clinical practice in the real world are called pragmatic trials. They are typically described as focusing on practical aspects of study design which include the recruitment and consent process, as well as 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 employed various investigators and participants from various geographical areas. This kind of heterogeneity is essential for pragmatic trials to be valid and also helps to reduce bias in the results. However too much heterogeneity could lead to issues with the design of the trial.
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Pragmatic Play offers not only mobile-friendly slot machines but also live casino and table games. The company is licensed and is regulated by various regulatory bodies that include the Malta Gaming Authority and UK Gambling Commission. The games are supported by the latest encryption technology, and the company's security team is always available to assist players with any issues they might have.
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Legality
Pragmatic Play has earned a name for itself by providing top-quality games and an outstanding user experience. Its software is designed to work with mobile devices and supports multiple languages. Despite its infancy it has established itself as a top gaming platform for casinos. The latest releases include Wolves which is a five-reel video slot with a healthy RTP and impressive graphics. Other notable titles include Wolf Gold and Chilli Heat.
Pragmatic trials aim to mimic real-life settings and achieve maximum external validity. They are usually requested by practitioners and policymakers in order to inform their decisions. They can be used to determine the cause-effect relationship of an intervention with its outcomes. However, they shouldn't be used to substitute for explanation studies.
The concept of pragmatism is controversial and there are doubts about whether pragmatic trials should replace tests for explanations or if they should be an addition to them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which confirm a physiological or clinical hypothesis and pragmatic trials that inform policy and practice decisions. They also suggested the framework for pragmatic trials, which they called PRECIS.2 This tool was designed to define the elements of a pragmatic study that include the recruitment process, the design and delivery of the intervention, and follow-up.
The number of pragmatic trials is increasing. A recent Medline query that used the words pragmatic and naturalistic, which was restricted to randomised controlled trials (RCTs) returned 34 articles. These are highlighted in red on Figure 2. This indicates that the health science community is becoming more sensitive to the subject of pragmatic thinking. It is important to note that the majority of studies were conducted in primary-care settings.