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Pragmatic trials are studies designed to inform the practice of clinical trials in real life. They are often described by their focus on practical aspects of designing a study, including the recruitment and consent process, as well as adherence and the use of standard equipment.
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A practical trial that employs different investigators and participants from different geographical areas is the Home Blood Pressure Management study (HBPM). This kind of heterogeneity is required for pragmatic trials to be able to prove their validity, and it also helps reduce bias in the results. However too much heterogeneity could result in problems with the design of the trial.
Pragmatic Play Pragmatic Play, one of the biggest players on the live casino market offers an array of traditional table games like Blackjack and Roulette. The live studios of the company in Romania and Malta provide a genuine gambling experience for customers, as well as a full suite of virtual betting options. The company has also developed several interactive game shows to make gambling online enjoyable. Some of these shows have live hosts, whereas others are hosted by famous personalities from the industry.
Mobile compatibility
Pragmatic Play is a new player in the world of online casinos however, it has already made a name for itself with its mobile-friendly slots. Their games are optimized for mobile devices and are powered by HTML5 technology. They are also licensed and regulated by trusted gaming authorities, which ensure fairness and transparency. This is a positive indicator for players, since it means that the games have been checked and verified to ensure that the results of every round are fair and impartial.
Pragmatic Play offers not only mobile-friendly slot machines as well as live casino and table games. The company is licensed by a variety of regulatory bodies which include Malta Gaming Authority and UK Gambling Commission. The company's games are secured with high-end encryption and its security team is available to assist players in any situation.
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Legality
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Pragmatic trials seek to replicate real-world situations and have the highest external validity. They are usually commissioned by policymakers and practitioners in order to inform their decisions. They can also be used to assess the causality of an intervention and its effects. However, they should not be used to substitute for the use of explanation studies.
The concept of pragmatism is controversial and there are doubts about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which confirm the clinical or physiological hypothesis and pragmatic trials, which guide the practice and policy decisions. They also suggested an approach to pragmatic trials, which they called PRECIS.2 This tool attempted to define the characteristics of a practical trial, including the recruitment process, the design and implementation of the intervention, as well as follow-up.
There is a growing increase in the number pragmatic trials that are published. A recent Medline search using the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs) returned 34 articles. These are highlighted in red on Figure 2. This indicates that the health sciences community has become more aware of the importance of pragmatism. It is important to remember, however, that the majority of studies were conducted in primary-care settings.