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Clinical trials that are designed to help inform practice in the real world are called pragmatic trials. They are typically described by their focus on practical aspects of design that include the recruitment process and consent, adhering and the use of standard equipment.

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Pragmatic is a software company that provides a variety of casino games available on online gambling platforms. Its iGaming software is used by leading operators and land based casinos. The company provides front-end site design tools, analysis and marketing, promotions, security, payment systems, customer support and bug reporting. The company also offers security, high-quality graphics, games and security.

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A pragmatic study that involves different investigators and participants from different geographical areas is the Home Blood Pressure Management study (HBPM). This type of heterogeneity which is essential for a pragmatic trial to be reliable and lessen the chance of bias is also essential. However too much heterogeneity could cause problems with the design of the trial.

Pragmatic Play is also a major player in the live casino market, providing an array of classic table games such as Blackjack and Roulette in various versions. The live studios of the company in Romania and Malta provide a genuine gaming experience for its customers, as well as a wide range of virtual betting options. The company has also created several interactive game shows to make online gambling fun. Some of these shows feature live hosts, whereas others are hosted by prominent personalities from the industry.

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Pragmatic Play is renowned for its top-notch games, and also for providing an outstanding user experience. Its software is accessible on mobile devices and in a variety of languages. Despite its relative youth it has established itself as a top casino gaming platform. Wolves is one of the most recent releases that is a 5-reel slot machine that has a high RTP and impressive graphics. Other notable titles include Wolf Gold and Chilli Heat.

The aim of pragmatic trials is to replicate real-life situations and achieve maximum credibility externally. Usually, they are requested by practitioners and policymakers to guide their decisions. They also provide a useful method to determine the causal relationship between an intervention and its results. However, they should not be used as a substitute for explanatory trials.

The concept of pragmatism is controversial and there are concerns about whether pragmatic trials can replace tests for explanations or if they are an addition to them. Schwartz and Lellouch1 made the distinction between explanation studies, which prove the validity of a physiological or clinical hypothesis, as well as pragmatic trials that aid in the decision-making process for policy and practice. They also proposed a framework for pragmatic trials, which they called PRECIS.2 This tool attempted to define the features of a practical trial which includes the recruitment process, the design and delivery of the intervention, as well as monitoring.

There is an encouraging increase in the number pragmatic trials that are published. 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 is an indication that the health sciences community is becoming increasingly sensitized to the issue of pragmatism. However, it is important to remember that the majority of these trials were conducted in primary care settings.