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Wolves is one of its latest releases that is a 5-reel slot machine with a healthy RTP and impressive graphics. Other notable titles include Wolf Gold and Chilli Heat.The purpose of pragmatic trials is to mimic real-life scenarios and gain maximum validity externally. They are usually ordered by policymakers and practitioners in order to inform their decisions. They also provide a useful method of determining the cause-effect relationship between an intervention and its outcomes. They should not, however, be used to replace the need for explanation studies.The pragmatism concept is controversial and there are doubts about whether pragmatic trials should replace or complement them. Schwartz and Lellouch1 made a distinction between explanatory studies, which support the physiological hypothesis or clinical hypothesis, and pragmatic trials, that inform policy and practice decision-making. They also proposed a framework called PRECIS for pragmatic trials.2 This tool attempted to define the characteristics of a practical study, including the recruitment, design, and delivery of the intervention and follow-up.The number of pragmatic trials is growing. A recent Medline search using the keywords pragmatic and naturalistic, restricted to randomized controlled trials (RCTs) produced 34 articles, shown in red in Figure 2. This suggests that the health sciences community has become more aware of the importance of pragmatic thinking. It is important to remember that the majority were conducted in primary-care settings.