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Its software can be used on mobile devices as well as in various languages. Despite its relative youth it has already established itself as a top gaming platform for casinos. Wolves is one of the most recent releases that is a 5-reel slot machine with a hefty RTP and stunning graphics. Other notable titles include Wolf Gold and Chilli Heat. Pragmatic trials aim to mimic real-life situations and attain maximum external validity. They are usually commissioned by policy makers and practitioners to aid in their decision-making. They can also be used 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 doubts regarding whether pragmatic trials could be used to replace explanation tests or if they should be a complement to them. Schwartz and Lellouch1 made the distinction between explanation studies, which prove the physiological hypothesis or clinical hypothesis, and pragmatic trials, that inform the decision-making process for policy and practice. They also suggested a framework dubbed PRECIS for pragmatic trials.2 This tool tried to define the elements of a pragmatic study, including the recruitment, design, and delivery of the intervention and its follow-up. The number of pragmatic trials is increasing. A recent Medline search using the terms naturalistic and pragmatic, limited to controlled trials randomized to control (RCTs) produced 34 articles, as shown in red in Figure 2. This suggests that the health sciences community is becoming more aware of the importance of pragmatism. It is important to remember that the majority of these studies were conducted in primary-care settings.
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