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Clinical trials that are designed to help inform practice in the real world are called pragmatic trials. They are often focused on practical aspects of the study design, including recruitment and consent in adherence, as well as the use of commonly available equipment.

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Pragmatic is a software developer that offers a broad range of casino games available on online gambling platforms. Its iGaming solutions are used by the leading operators and land-based casinos. The company offers front-end site design tools, analysis tools and promotions, marketing security payment systems, customer service, and bug reporting. The company also offers a safe environment with high-quality graphics, gaming and security.

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A practical trial that employs a variety investigators and includes participants from different geographical areas is the Home Blood Pressure Management study (HBPM). This type of heterogeneity, which is vital for a pragmatic trial to be valid and reduce bias in results is also essential. However, too much heterogeneity can cause issues with the design of the trial.

Pragmatic Play, one of the major players in the live casino market offers various classic table games like Blackjack and Roulette. The company's live studios in Romania and Malta provide a genuine gambling experience for customers and offer a wide range of virtual betting options. The company has also created various interactive games to make gambling online enjoyable. Some of these shows feature a live host, while others are hosted by famous personalities from the industry.

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Pragmatic Play is known for its top-notch games, and also for providing an outstanding user experience. Its software is designed to work on mobile devices and supports different languages. Despite its relatively young age it has already established itself as a top gaming platform for casinos. Wolves is one of its latest releases that is a 5-reel slot machine with a hefty RTP and impressive graphics. The other notable titles include Wolf Gold and Chilli Heat.

Pragmatic trials seek to replicate real-world situations and have the highest external validity. Usually, they are ordered by policymakers and practitioners in order to inform their decisions. They also provide a useful way to identify the cause-effect relationship between an intervention and its results. However, they should not, be used to replace explanatory studies.

The pragmatism idea is controversial, and there are concerns about whether pragmatic trials should replace explanatory trials or complement them. Schwartz and Lellouch1 proposed the distinction between explanation studies, which support the validity of a physiological or clinical hypothesis, as well as pragmatic trials that aid in policy and practice decision-making. They also suggested a framework known as PRECIS for pragmatic trials.2 This tool attempted to define the traits of a pragmatic study which includes recruitment, design, implementation of the intervention and follow-up.

There is a growing increase in the number of pragmatic trials that are published. A recent Medline query using the keywords naturalistic and pragmatic, restricted to randomised controlled trials (RCTs) returned 34 articles. These are shown in red on Figure 2. This suggests that the health sciences community is becoming more aware of the importance of pragmatic thinking. It is important to note that the majority of studies were conducted in primary care settings.