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Trials designed to inform clinical practice in the real world are referred to as pragmatic trials. They are typically described as focusing on practical aspects of design, including recruitment and consent, adherence and the use of routinely available equipment.
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Pragmatic is a software developer that provides a variety of casino games for online gambling platforms. Its iGaming software is used by top operators and land based casinos. The company provides front-end design tools, analysis tools, marketing, promotions, payment systems, security, customer support and bug reporting. The company also offers a safe environment with high-quality graphics, gameplay and security.
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Another example of a trial that is pragmatic is the Home Blood Pressure Management (HBPM) study, which utilized a variety of investigators and had participants from various geographical areas. This type of heterogeneity is required for pragmatic trials to be valid, and it also reduces bias in the results. However, too much heterogeneity could cause issues with the trial design.
Pragmatic Play is also a major player on the live casino market, providing an array of classic table games such as Blackjack and Roulette in a variety of versions. The live studios of Pragmatic Play in Romania and Malta provide customers with an authentic gambling experience, as well as a broad range of virtual betting options. The company also has several game shows which make online gambling fun and interactive. Some of these shows have live hosts, whereas others are hosted by prominent personalities from the industry.
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Legality
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Pragmatic trials are designed to replicate real-life settings and achieve maximum external validity. They are typically commissioned by policy makers and practitioners to aid in their decision-making. They also provide a useful method to determine the cause-effect relationship between the intervention and its effects. However, they shouldn't be used as a substitute for explanation trials.
The pragmatism idea is controversial and there are doubts about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 suggested the distinction between explanation trials, which validate the validity of a clinical or physiological hypothesis and pragmatic trials that inform the practice and policy decisions. They also suggested a framework dubbed PRECIS for pragmatic trials.2 The tool was designed to define the elements of a pragmatic study which includes the recruitment, design, and delivery of the intervention, and follow-up.
The number of pragmatic trials is growing. A recent Medline query using the keywords pragmatic and naturalistic, limited to randomised controlled trials (RCTs), returned 34 articles. They are displayed in red on Figure 2. This suggests that the health sciences community is becoming more aware of the importance of pragmatism. However, it is important to keep in mind that the majority of these studies were conducted in primary care settings.