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Pragmatic trials are studies designed to inform the practice of clinical trials in real life. They are often described by their focus on practical aspects of design which include the recruitment and consent process, as well as adherence and the use routinely available equipment.
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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which employed different investigators and had participants from different geographic areas. This type of heterogeneity which is vital for pragmatic trials to be valid and to reduce bias in the results is also essential. However too much heterogeneity could cause issues with the design of the trial.
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Pragmatic Play is renowned for its top-quality games and for offering an exceptional user experience. Its software is accessible on mobile devices as well as in various languages. Despite its relative youth it has established itself as a leading casino gaming platform. The latest releases include Wolves which is a five-reel video slot with a healthful RTP and stunning graphics. Other notable games include Wolf Gold and Chilli Heat.
The aim of pragmatic trials is to replicate real-life scenarios and gain the highest level of validity externally. They are usually commissioned by policymakers and practitioners in order to inform their decisions. They can also be used to assess the cause-effect relationship of an intervention and its results. However, they shouldn't be used to substitute for explanatory studies.
The pragmatism concept is controversial and there are questions about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which confirm the clinical or physiological hypothesis, and pragmatic trials that inform the practice and policy decisions. They also proposed an approach to pragmatic trials, which they called PRECIS.2 This tool sought to define the features of a pragmatic trial which includes the recruitment process, the design and delivery of the intervention, as well as follow-up.
The number of pragmatic trials is increasing. A recent Medline search using the terms naturalistic and pragmatic, limited to controlled trials randomized to control (RCTs), yielded 34 articles, which are shown in red in 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 of these studies were conducted in primary care settings.