Combining high quality data with rigorous methods: emulation of a target trial using electronic health records and a nested case-control design

Summary pointsCase-control studies are efficient designs for studies that require validation of key variables; data collection can occur on all cases and a sample of controls rather than on an entire cohortCase-control studies are vulnerable to several biases, including prevalent user bias and inappropriate adjustment for covariates when treatment and confounders are measured at the date when cases are identified and controls are sampled (ie, the index date)Emulating the design and analysis of a target randomized controlled trial can minimize some of these biases in comparative effectiveness case-control studiesThe proposed approach combines the benefits of measure validation in nested case-control designs with the strengths of target trial emulation, reducing biasRandomized controlled trials are considered the ideal study design for comparative effectiveness research. Given that such trials are usually costly, lengthy, and, in some instances, unethical or infeasible, interest is increasing in using observational studies such as those conducted using data…
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