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It has earned itself the status of one of the most popular casino gaming platforms despite its relatively young age. Wolves is one of its latest releases that is a 5-reel slot machine that has a high RTP and stunning graphics. Other notable titles include Wolf Gold and Chilli Heat. The purpose of pragmatic trials is to replicate real-life scenarios and to achieve maximum validity externally. They are usually commissioned by policy makers and practitioners to aid in their decision-making. They also provide a useful method of determining the causality between an intervention and its outcomes. They should, however, not be used to replace explanation studies. The idea of pragmatism is controversial and there are concerns about whether pragmatic trials can replace explanatory tests or if they are a complement to them. Schwartz and Lellouch1 made a distinction between explanatory studies, which prove a physiological hypothesis or clinical hypothesis, as well as pragmatic trials, which inform the practice and policy decision-making. They also suggested the framework for pragmatic trials, called PRECIS.2 This tool attempted to define the elements of a practical trial that include the recruitment process, the design and delivery of the intervention, and monitoring. There is an encouraging trend in the number of pragmatic trials published. A recent Medline query using the keywords naturalistic and pragmatic, restricted 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 pragmatic thinking. It is important to keep in mind that the majority were conducted in primary-care settings.
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