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Pragmatic trials are trials designed to inform the practice of clinical trials in real life. They are typically focused on the practical aspects of study design, including the recruitment process and consent, adherence, and the use of commonly 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 able to prove their validity, and it also helps reduce the chance of bias in the results. However, too much heterogeneity can lead to issues with the design of the trial.

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Legality

Pragmatic Play is known for its top-notch games, and for offering an exceptional user experience. Its software is designed to work on mobile devices and supports various languages. Despite its relatively young age, it has already established itself as a premier casino gaming platform. Its latest releases include Wolves 5 reel video slot with a healthful RTP and stunning graphics. Other notable titles include Wolf Gold and Chilli Heat.

The goal of pragmatic trials is to mimic real-life scenarios and gain maximum credibility externally. Usually, they are requested by practitioners and policymakers in order to guide their decisions. They also provide a useful way to identify the cause-effect relationship between the intervention and its effects. However, they shouldn't be used as a substitute for explanatory trials.

The idea of pragmatism is controversial, and there are questions about whether pragmatic trials can replace explanatory tests or if they should serve as a complement to them. Schwartz and Lellouch1 suggested the distinction between explanation studies, which support a physiological hypothesis or clinical hypothesis, and pragmatic trials, that inform policy and practice decision-making. They also proposed a framework called PRECIS for pragmatic trials.2 This tool attempted to define the elements of a practical study which includes recruitment, design, implementation of the intervention and its follow-up.

The number of pragmatic trials is growing. A recent Medline query that used the words pragmatic and naturalistic, limited 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 keep in mind that the majority of studies were conducted in primary-care settings.