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Clinical trials that are designed to help inform practice in the real world are referred to as pragmatic trials. They are often characterized as focusing on practical aspects of design which include recruitment and consent, adherence and the use of routinely available equipment.

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A pragmatic study that involves different investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This type of heterogeneity is required for pragmatic trials to be valid, and it also reduces the chance of bias in the results. Too much heterogeneity, however could cause issues with the trial design.

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Pragmatic Play has earned a name for itself by providing high-quality games and a superior user experience. The software is available on mobile devices as well as in various languages. Despite its infancy it has established itself as a leading gaming platform for casinos. The latest releases include Wolves 5 reel video slot with a healthy RTP and stunning graphics. Its other notable titles are Wolf Gold and Chilli Heat.

Pragmatic trials are designed to replicate real-life situations and attain maximum external validity. Usually, they are requested by practitioners and policymakers to inform their decisions. They can also be used to determine the causal relationship between an intervention and its results. They should not, however, be used to replace the need for explanation studies.

The concept of pragmatism is controversial, and there are questions about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 suggested a distinction between explanatory studies, which prove the physiological hypothesis or clinical hypothesis, as well as pragmatic trials, which inform policy and practice decision-making. They also suggested a framework known as PRECIS for pragmatic trials.2 This tool attempted to define the elements of a pragmatic research study which includes recruitment, design, delivery of the intervention and its 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, as shown in red in Figure 2. This indicates that the health science community is becoming more sensitive to the issue of pragmatism. However, it is important to keep in mind that the majority of these trials were conducted in primary care settings.