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Pragmatic trials are those that are designed to provide information for real-world clinical practice. They are typically focused on practical aspects of the research design, like the recruitment and consent process as well as adherence to the use of routinely available equipment.

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Pragmatic is a software development company that offers a wide range of casino games for online gambling platforms. Pragmatic's iGaming solutions are used by the most reputable operators as well as casinos with a physical location. The company offers front-end website design tools, analysis tools and marketing, promotions security, payment systems, customer service and bug-reporting. In addition, the company provides its users a safe environment with high-quality graphics as well as gaming.

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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which employed a variety of investigators and participants from various geographical areas. This kind of heterogeneity, that is crucial for a pragmatic trial to be valid and lessen the chance of bias is also essential. A high degree of heterogeneity, however could cause issues with the trial design.

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The aim of pragmatic trials is to replicate real-life scenarios and gain the highest level of validity externally. They are usually requested by practitioners and policymakers to help guide their decisions. They can be used to determine the causal relationship between an intervention with its outcomes. They should, however, not, be used to replace the need for explanation studies.

The pragmatism idea is controversial, and there are questions about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 suggested the 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 the framework for pragmatic trials, dubbed PRECIS.2 This tool was designed to define the elements of a pragmatic trial, including recruitment, design and delivery of the intervention, and the follow-up.

The number of pragmatic trials is growing. A recent Medline query that used the words pragmatic and naturalistic, which was restricted to randomised controlled trials (RCTs) returned 34 articles. These are shown in red on Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatic thinking. It is important to note that the majority of these studies were conducted in primary-care settings.