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The most recent releases include Wolves, a 5-reel video slot with a healthful RTP and impressive graphics. The other notable titles include Wolf Gold and Chilli Heat. Pragmatic trials are designed to replicate real-life situations and attain maximum external validity. They are typically commissioned by practitioners and policy makers to aid in their decision-making. They can also be a great method of determining the causal relationship between an intervention and its results. However, they should not be used to replace the need for explanation studies. The concept of pragmatism is controversial, and there are questions about whether pragmatic trials should be used to replace explanatory trials or complement them. Schwartz and Lellouch1 made the distinction between explanation studies, which support the validity of a physiological or clinical hypothesis, as well as pragmatic trials, that inform policy and practice decision-making. They also suggested the framework for pragmatic trials, called PRECIS.2 This tool was designed to define the characteristics of a pragmatic study, including the recruitment process, the design and delivery of the intervention, and the follow-up. The number of pragmatic trials is growing. A recent Medline search using the words pragmatic and naturalistic, limited to randomised controlled trials (RCTs) returned 34 articles. These are shown in red on Figure 2. This is a sign that the health sciences community is becoming more acquaint to the subject of pragmatics. It is important to remember that the majority were conducted in primary care settings.