More Than Big Data Needed for Estimates as Good as Randomized Clinical Trials: Prospective Observational Causal Studies

A research methods post…

Bill Gardner is cautiously—very cautiously—hopeful that big data from electronic health records (EHRs) will enable unbiased estimates of the effects of medical treatment, without any randomized controlled trials.  Gardner’s hope, his caution and his description of the data needed—“all the factors that determine who gets what treatment”—are all right on the mark. And EHRs will massively increase data on detailed clinical factors that drive clinical decisions.

But I fear researchers will focus only on the data laying around in EHRs. To cure confounding, you need to go out and measure all the confounders—everything related to both treatment and outcome. Continue reading

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