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Wolves is one of the most recent releases, a 5-reel slot machine that has a high RTP and impressive graphics. Other notable games include Wolf Gold and Chilli Heat.The aim of pragmatic trials is to mimic real-life scenarios and to achieve the highest level of validity externally. Usually, they are requested by practitioners and policymakers in order to guide their decisions. They can be used to determine the causality of an intervention with its outcomes. They should not, however be used to replace explanatory studies.The idea of pragmatism is controversial, and there are questions about whether pragmatic trials can replace explanatory tests or if they should be a complement to them. Schwartz and Lellouch1 suggested the distinction between explanatory trials, which validate a physiological or clinical hypothesis, and pragmatic trials, which inform the policy and practice of. They also proposed a framework called PRECIS for pragmatic trials.2 The tool was designed to define the characteristics of a pragmatic study that includes recruitment, design, delivery of the intervention and follow-up.There is a positive increase in the number of pragmatic trials published. A recent Medline query using the keywords pragmatic and naturalistic, limited to randomised controlled trials (RCTs) returned 34 articles. These are shown in red on Figure 2. This is an indication that the health sciences community is becoming increasingly sensitized to the issue of pragmatism. However, it is important to keep in mind that the majority of these studies were conducted in primary care settings.