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Pragmatic trials are those that are designed to provide information for the practice of clinical trials in real life. They are typically characterized by a focus on the practical aspects of study design, such as the recruitment process and consent in adherence, as well as the use of routinely available equipment.
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A practical trial that employs a variety investigators and includes 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 helps reduce bias in the results. Too much heterogeneity, however can result in problems with the design of the trial.
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Pragmatic Play is a relatively new player in the online casino market however, it has already earned a name through its mobile-friendly slot machines. Their games are optimized for mobile devices and run using HTML5 technology. They are also certified and regulated by reputable gaming authorities, ensuring fairness and transparency. This is a positive sign for players as it means the games have been thoroughly tested and verified in order to guarantee the randomness and fairness of every game.
Pragmatic Play offers not only mobile-friendly slot machines as well as table games and live casino. The company is licensed and regulated by several governing bodies that include the Malta Gaming Authority and UK Gambling Commission. The games offered by the company are secured with high-end encryption and its security staff is on hand to assist players with any issues.
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Legality
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The aim of pragmatic trials is to replicate real-life situations and achieve the highest level of validity externally. They are typically commissioned by policy makers and practitioners to inform their decision making. They also provide a useful method of determining the cause-effect relationship between an intervention and its results. They should, however, not be used to replace explanation studies.
The pragmatism concept is controversial, and there are doubts about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 suggested an distinction between explanation-based studies, which support the validity of a physiological or clinical hypothesis, and pragmatic trials, that inform policy and practice decision-making. They also suggested a framework known as PRECIS for pragmatic trials.2 This tool attempted to define the characteristics of a pragmatic study, including the recruitment, design, and delivery of the intervention and its follow-up.
The number of pragmatic trials is increasing. A recent Medline search using the keywords pragmatic and naturalistic, restricted to controlled trials randomized to control (RCTs), yielded 34 articles, shown in red in Figure 2. This indicates that the health sciences community is becoming more acquaint to the issue of pragmatics. It is important to keep in mind that the majority were conducted in primary-care settings.