Observational studyJournal of clinical epidemiology2018
Electronic medical records can be used to emulate target trials of sustained treatment strategies.
Observational study in Journal of clinical epidemiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
67 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Chemoprevention of Barrett's Esophagus: a Systematic Review and Comprehensive Assessment of Bias.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2025Pooled it
- Reporting of Observational Studies Explicitly Aiming to Emulate Randomized Trials: A Systematic Review.JAMA network open · 2023Pooled it
- Estimating the effect of pravastatin vs usual care under full adherence in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial-Lipid Lowering Trial.American journal of epidemiology · 2026Trial
- Comparative Effectiveness Analysis of Lumpectomy and Mastectomy for Elderly Female Breast Cancer Patients: A Deep Learning-based Big Data Analysis.The Yale journal of biology and medicine · 2023Trial
- Hybrid immunity against reinfection with SARS-CoV-2 following a previous SARS-CoV-2 infection and single dose of the BNT162b2 vaccine in children and adolescents: a target trial emulation.The Lancet. Microbe · 2023Trial
- Trial
- Sustained Use of SGLT2 Inhibitors and Cardiovascular Outcomes in Older Adults: A Landmark Cohort Study.Diabetes, obesity & metabolism · 2026Article
- Long-term outcomes associated with continued use of ARBs versus CCBs in older adults: a landmark cohort study.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- Risk of gastrointestinal bleeding with gabapentin versus duloxetine in older adults with neuropathic pain: a target trial emulation cohort study.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Angiotensin receptor blockers and dementia risk in older adults: A target trial emulation.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Emulating a target trial of surgical removal of uterine fibroids on atherosclerotic cardiovascular disease.Fertility and sterility · 2026Article
- Unaddressed methodological flaws in the evaluation of SGLT2 inhibitors in systemic lupus erythematosus.International urology and nephrology · 2026Article
- Angiotensin Receptor Blockers Versus Calcium Channel Blockers for First-Line Antihypertensive Therapy and Survival in Adults Aged 75 Years or Older.Journal of the American Geriatrics Society · 2026Article
- Sodium-Glucose Cotransporter 2 Inhibitors and Dementia Risk in Patients With Psychiatric Disorders.JAMA network open · 2026Article
- An operational target trial emulation framework for causal inference using electronic health record data.NPJ digital medicine · 2026Review
- Natural history of self-reported symptoms following SARS-CoV-2 infection: A target trial emulation in a prospective community-recruited cohort.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026Article
- Design and Implementation of Observational Studies Emulating a Target Trial.JAMA network open · 2026Article
- Network-based prediction and real-world patient data observation identify doxycycline as a repurposable drug in Alzheimer's disease.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Article
- Population-Level Evidence That Alcohol Brief Interventions Improve Drinking and Blood Pressure Outcomes in Patients With Hypertension and Unhealthy Alcohol Use.Journal of studies on alcohol and drugs · 2026Observational
- Optimised comorbidity indices can reflect patient performance status in register based studies of prostate cancer.Scientific reports · 2025Article
7 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
objectiveTo emulate three target trials: single treatment vs. no treatment, joint treatment vs. no treatment, and head-to-head comparison of two treatments, we explain how to estimate the observational analogs of intention-to-treat and per-protocol effects, using hazard ratios and survival curves. For per-protocol effects, we describe two methods for adherence adjustment via inverse-probability weighting. STUDY DESIGN AND
settingProspective observational study using electronic medical records of individuals aged 55-84 with coronary heart disease from >500 practices in the United Kingdom between 2000 and 2010.
resultsThe intention-to-treat mortality hazard ratio (95% confidence interval) was 0.90 (0.84, 0.97) for statins vs. no treatment, 0.88 (0.73, 1.06) for statins plus antihypertensives vs. no treatment, and 0.91 (0.77, 1.06) for atorvastatin vs. simvastatin. When censoring nonadherent person-times, the per-protocol mortality hazard ratio was 0.74 (0.64, 0.85) for statins vs. no treatment, 0.55 (0.35, 0.87) for statins plus antihypertensives vs. no treatment, and 1.13 (0.88, 1.45) for atorvastatin vs. simvastatin. We estimated per-protocol hazard ratios for a 5-year treatment using different dose-response marginal structural models and standardized survival curves for each target trial using intention-to-treat and per-protocol analyses.
conclusionWhen randomized trials are not available or feasible, observational analyses can emulate a variety of target trials.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.