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Other notable titles include Wolf Gold and Chilli Heat.Pragmatic trials seek to replicate real-world situations and have the highest external validity. They are typically commissioned by policymakers and practitioners in order to guide their decisions. They are also a good method to determine the causality between an intervention and its outcomes. However, they should not be used as a substitute for explanatory trials.The pragmatism idea is controversial, and there are questions about whether pragmatic trials can be used to replace explanation tests or if they are an addition to them. Schwartz and Lellouch1 made an distinction between explanation-based studies, which support a physiological hypothesis or clinical hypothesis, and pragmatic trials, which inform the decision-making process for policy and practice. 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