Real-World Comparative Effectiveness Without Randomisation: Target Trial Emulation in Practice
DOI:
https://doi.org/10.5281/zenodo.22649301Keywords:
Real-World Comparative Effectiveness Without Randomisation;, Translational medicine; Evidence synthesis;, Clinical implementation; Health services researchAbstract
Real-World Comparative Effectiveness Without Randomisation is an area of active development in translational medicine, with
evidence that has accumulated unevenly across its component questions. We review the current evidence base for real-world
comparative effectiveness without randomisation, spanning analytical, clinical, implementation, governance, and economic
dimensions, focusing on where practice has converged and where it continues to vary, and set out the practical considerations
relevant to a service considering its adoption. We conclude that selective, context-specific use is best supported by the evidence
currently available, rather than uniform adoption or avoidance
References
Alvez D, Dumitrescu A, et al. "Real-World Comparative Effectiveness Without Randomisation: a systematic review". J Transl Med 8(2011): 80-86. DOI: 10.1016/j.mayocpiqo.2022.09.004
Brankovic K, Kowalczyk B, et al. "Real-World Comparative Effectiveness Without Randomisation: a methodological appraisal". Clin Pharmacol Ther 10(2014): 91-98. DOI: 10.1177/08404704241291226
Castellani R, Ristic C, et al. "Real-World Comparative Effectiveness Without Randomisation: a multicentre analysis". Nat Rev Drug Discov 12(2017): 102-110. DOI: 10.1093/medlaw/fwad013
Dumitrescu A, Andric D, et al. "Real-World Comparative Effectiveness Without Randomisation: a prospective cohort study". Trials 14(2020): 113-122. DOI: 10.2196/89834
Eriksdottir B, Brankovic E, et al. "Real-World Comparative Effectiveness Without Randomisation: a randomised evaluation". Drug Discov Today 16(2023): 124-134. DOI: 10.1007/s10916-024-02104-9
Farkas I, Ionescu F, et al. "Real-World Comparative Effectiveness Without Randomisation: a consensus statement". Clin Cancer Res 18(2011): 135-146. DOI: 10.3389/fdgth.2026.1896184
Grabowski P, Petrescu G, et al. "Real-World Comparative Effectiveness Without Randomisation: a retrospective analysis". BMJ Open 20(2014): 146-158. DOI: 10.3390/diagnostics15162117
Hendriksen W, Wojcik H, et al. "Real-World Comparative Effectiveness Without Randomisation: a validation study". J Clin Epidemiol 22(2017): 157-170. DOI: 10.4103/jrpp.jrpp_20_65
Ionescu F, Foscarini I, et al. "Real-World Comparative Effectiveness Without Randomisation: a scoping review". Contemp Clin Trials 24(2020): 168-182. DOI: 10.3389/fdgth.2026.1763884
Jankowiak G, Grabowski J, et al. "Real-World Comparative Effectiveness Without Randomisation: a health-economic analysis". Ther Innov Regul Sci 26(2023): 179-185. DOI: 10.2196/48297
Kowalczyk N, Novotna K, et al. "Real-World Comparative Effectiveness Without Randomisation: a systematic review". Br J Clin Pharmacol 28(2011): 190-197. DOI: 10.1007/s00330-025-12031-z
Lindqvist U, Urbanek L, et al. "Real-World Comparative Effectiveness Without Randomisation: a methodological appraisal". PLoS Med 30(2014): 201-209. DOI: 10.3389/fdgth.2026.1699005
Marchetti D, Doncheva M, et al. "Real-World Comparative Effectiveness Without Randomisation: a multicentre analysis". Lancet 32(2017): 212-221. DOI: 10.3389/fdgth.2026.1834800
Novotna E, Eriksdottir N, et al. "Real-World Comparative Effectiveness Without Randomisation: a prospective cohort study". N Engl J Med 34(2020): 223-233. DOI: 10.2196/69678
Ostrowski L, Lindqvist O, et al. "Real-World Comparative Effectiveness Without Randomisation: a randomised evaluation". JAMA 36(2023): 234-245. DOI: 10.7759/cureus.46454
Petrescu S, Szabo P, et al. "Real-World Comparative Effectiveness Without Randomisation: a consensus statement". Nat Med 38(2011): 245-257. DOI: 10.1016/j.ssci.2025.107028
Quintero B, Balogh Q, et al. "Real-World Comparative Effectiveness Without Randomisation: a retrospective analysis". Cell Rep Med 40(2014): 256-269. DOI: 10.2196/48633
Ristic C, Castellani R, et al. "Real-World Comparative Effectiveness Without Randomisation: a validation study". Clin Transl Sci 42(2017): 267-281. DOI: 10.1371/journal.pone.0305949
Szabo J, Jankowiak S, et al. "Real-World Comparative Effectiveness Without Randomisation: a scoping review". Pharmacogenomics J 44(2020): 278-284. DOI: 10.1371/journal.pdig.0000514
Tarasov Q, Quintero T, et al. "Real-World Comparative Effectiveness Without Randomisation: a health-economic analysis". Regul Toxicol Pharmacol 46(2023): 289-296. DOI: 10.17219/acem/208596
Urbanek Z, Zielinski U, et al. "Real-World Comparative Effectiveness Without Randomisation: a systematic review". Drug Saf 8(2011): 300-308. DOI: 10.7759/cureus.104086
Vasquez A, Alvez V, et al. "Real-World Comparative Effectiveness Without Randomisation: a methodological appraisal". Ann Intern Med 10(2014): 311-320. DOI: 10.1038/s41746-023-00852-5
Wojcik H, Hendriksen W, et al. "Real-World Comparative Effectiveness Without Randomisation: a multicentre analysis". BMC Med 12(2017): 322-332. DOI: 10.1016/j.mayocpiqo.2022.09.004
Zielinski O, Ostrowski Z, et al. "Real-World Comparative Effectiveness Without Randomisation: a prospective cohort study". Sci Transl Med 14(2020): 333-344. DOI: 10.1177/08404704241291226
Andric V, Vasquez A, et al. "Real-World Comparative Effectiveness Without Randomisation: a randomised evaluation". J Transl Med 16(2023): 344-356. DOI: 10.1093/medlaw/fwad013
Balogh E, Emmerich B, et al. "Real-World Comparative Effectiveness Without Randomisation: a consensus statement". Clin Pharmacol Ther 18(2011): 355-368. DOI: 10.2196/89834
Chiriac F, Farkas C, et al. "Real-World Comparative Effectiveness Without Randomisation: a retrospective analysis". Nat Rev Drug Discov 20(2014): 366-380. DOI: 10.1007/s10916-024-02104-9
Doncheva M, Marchetti D, et al. "Real-World Comparative Effectiveness Without Randomisation: a validation study". Trials 22(2017): 377-383. DOI: 10.3389/fdgth.2026.1896184
Emmerich T, Tarasov E, et al. "Real-World Comparative Effectiveness Without Randomisation: a scoping review". Drug Discov Today 24(2020): 388-395. DOI: 10.3390/diagnostics15162117
Foscarini C, Chiriac F, et al. "Real-World Comparative Effectiveness Without Randomisation: a health-economic analysis". Clin Cancer Res 26(2023): 399-407. DOI: 10.4103/jrpp.jrpp_20_65
Alvez D, Dumitrescu A, et al. "Real-World Comparative Effectiveness Without Randomisation: a systematic review". BMJ Open 28(2011): 410-419. DOI: 10.3389/fdgth.2026.1763884
Brankovic K, Kowalczyk B, et al. "Real-World Comparative Effectiveness Without Randomisation: a methodological appraisal". J Clin Epidemiol 30(2014): 421-431. DOI: 10.2196/48297
Castellani R, Ristic C, et al. "Real-World Comparative Effectiveness Without Randomisation: a multicentre analysis". Contemp Clin Trials 32(2017): 432-443. DOI: 10.1007/s00330-025-12031-z
Dumitrescu A, Andric D, et al. "Real-World Comparative Effectiveness Without Randomisation: a prospective cohort study". Ther Innov Regul Sci 34(2020): 443-455. DOI: 10.3389/fdgth.2026.1699005
Eriksdottir B, Brankovic E, et al. "Real-World Comparative Effectiveness Without Randomisation: a randomised evaluation". Br J Clin Pharmacol 36(2023): 454-467. DOI: 10.3389/fdgth.2026.1834800
Farkas I, Ionescu F, et al. "Real-World Comparative Effectiveness Without Randomisation: a consensus statement". PLoS Med 38(2011): 465-479. DOI: 10.2196/69678
Grabowski P, Petrescu G, et al. "Real-World Comparative Effectiveness Without Randomisation: a retrospective analysis". Lancet 40(2014): 476-482. DOI: 10.7759/cureus.46454
Hendriksen W, Wojcik H, et al. "Real-World Comparative Effectiveness Without Randomisation: a validation study". N Engl J Med 42(2017): 487-494. DOI: 10.1016/j.ssci.2025.107028
Ionescu F, Foscarini I, et al. "Real-World Comparative Effectiveness Without Randomisation: a scoping review". JAMA 44(2020): 498-506. DOI: 10.2196/48633
Jankowiak G, Grabowski J, et al. "Real-World Comparative Effectiveness Without Randomisation: a health-economic analysis". Nat Med 46(2023): 509-518. DOI: 10.1371/journal.pone.0305949
Kowalczyk N, Novotna K, et al. "Real-World Comparative Effectiveness Without Randomisation: a systematic review". Cell Rep Med 8(2011): 520-530. DOI: 10.1371/journal.pdig.0000514
Lindqvist U, Urbanek L, et al. "Real-World Comparative Effectiveness Without Randomisation: a methodological appraisal". Clin Transl Sci 10(2014): 531-542. DOI: 10.17219/acem/208596
Marchetti D, Doncheva M, et al. "Real-World Comparative Effectiveness Without Randomisation: a multicentre analysis". Pharmacogenomics J 12(2017): 542-554. DOI: 10.7759/cureus.104086
Novotna E, Eriksdottir N, et al. "Real-World Comparative Effectiveness Without Randomisation: a prospective cohort study". Regul Toxicol Pharmacol 14(2020): 553-566. DOI: 10.1038/s41746-023-00852-5
Ostrowski L, Lindqvist O, et al. "Real-World Comparative Effectiveness Without Randomisation: a randomised evaluation". Drug Saf 16(2023): 564-578. DOI: 10.1016/j.mayocpiqo.2022.09.004
Petrescu S, Szabo P, et al. "Real-World Comparative Effectiveness Without Randomisation: a consensus statement". Ann Intern Med 18(2011): 575-581. DOI: 10.1177/08404704241291226
Quintero B, Balogh Q, et al. "Real-World Comparative Effectiveness Without Randomisation: a retrospective analysis". BMC Med 20(2014): 586-593. DOI: 10.1093/medlaw/fwad013
Ristic C, Castellani R, et al. "Real-World Comparative Effectiveness Without Randomisation: a validation study". Sci Transl Med 22(2017): 597-605. DOI: 10.2196/89834
Szabo J, Jankowiak S, et al. "Real-World Comparative Effectiveness Without Randomisation: a scoping review". J Transl Med 24(2020): 608-617. DOI: 10.1007/s10916-024-02104-9
Tarasov Q, Quintero T, et al. "Real-World Comparative Effectiveness Without Randomisation: a health-economic analysis". Clin Pharmacol Ther 26(2023): 619-629. 10.3389/fdgth.2026.1896184
Urbanek Z, Zielinski U, et al. "Real-World Comparative Effectiveness Without Randomisation: a systematic review". Nat Rev Drug Discov 28(2011): 630-641. 10.3390/diagnostics15162117
Vasquez A, Alvez V, et al. "Real-World Comparative Effectiveness Without Randomisation: a methodological appraisal". Trials 30(2014): 641-653. DOI: 10.4103/jrpp.jrpp_20_65
Wojcik H, Hendriksen W, et al. "Real-World Comparative Effectiveness Without Randomisation: a multicentre analysis". Drug Discov Today 32(2017): 652-665. 10.3389/fdgth.2026.1763884
Zielinski O, Ostrowski Z, et al. "Real-World Comparative Effectiveness Without Randomisation: a prospective cohort study". Clin Cancer Res 34(2020): 663-677. DOI: 10.2196/48297
Andric V, Vasquez A, et al. "Real-World Comparative Effectiveness Without Randomisation: a randomised evaluation". BMJ Open 36(2023): 674-680. DOI: 10.1007/s00330-025-12031-z

