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Pragmatic trials are trials designed to provide information for the practice of clinical trials in real life. They are often described as a focus on the practical aspects of study design that include the recruitment process and consent, adhering and the use routinely available equipment.

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Pragmatic is a software company, offers a variety of casino games on online gambling platforms. Pragmatic's iGaming software is used by leading operators as well as land-based casinos. The company offers front-end tools for design, analysis, marketing, promotions payment systems, security, customer service, and bug reporting. Additionally, the company offers its players a safe and secure environment that features high-quality graphics and gameplay.

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A practical trial that employs different investigators and participants from diverse geographical locations is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is necessary for practical trials to be valid, and it also helps reduce bias in the results. Too much heterogeneity, however, can cause problems with the trial design.

Pragmatic Play is also a major player on the live casino market, providing an array of table games like as Blackjack and Roulette in various versions. The company's live studios in Romania and Malta offer a real-life gaming experience for its customers, as well as an extensive selection of virtual betting options. The company also offers a variety of game shows that make online gambling more exciting and interactive. Some of these shows are broadcast live and others are hosted by famous personalities from the field.

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In addition to their mobile-friendly slot machines, Pragmatic Play also offers live dealer casinos. Pragmatic Play is licensed and regulated by several governing bodies which include the Malta Gaming Authority and UK Gambling Commission. The games offered by the company are protected by high-end encryption and its security staff is on hand to assist players in any situation.

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The aim of pragmatic trials is to mimic real-life scenarios and to achieve maximum credibility externally. Usually, they are requested by practitioners and policymakers in order to inform their decisions. They can also be used to determine the causal relationship between an intervention and its results. However, they should not be used to substitute for explanation studies.

The idea of pragmatism is controversial, and there are questions about whether pragmatic trials can be used to replace explanation tests or if they should be an addition to them. Schwartz and Lellouch1 suggested a distinction between explanatory trials, which validate the validity of a clinical or physiological hypothesis as well as pragmatic trials, which guide the practice and policy decisions. They also proposed a framework for pragmatic trials, called PRECIS.2 This tool was designed to define the features of a pragmatic trial that include recruitment, design and delivery of the intervention, and follow-up.

There is an encouraging increase in the number pragmatic trials published. A recent Medline search using the keywords naturalistic and pragmatic, limited to randomized controlled trials (RCTs), yielded 34 articles, which are shown in red in Figure 2. This is an indication that the health science community is becoming increasingly sensitized to the subject of pragmatism. It is important to keep in mind that the majority of these studies were conducted in primary-care settings.