The DOI matches its Crossref record; 8 of the 8 references it cites were found in a registry or an index.
Nonrandomized real-world evidence to support regulatory decision making: process for a randomized trial replication project
Abstract
Recent legislation mandates that the US Food and Drug Administration issue guidance regarding when real‐world evidence (RWE) could be used to support regulatory decision making. Although RWE could come from randomized or nonrandomized designs, there are significant concerns about the validity of RWE assessing medication effectiveness based on nonrandomized designs. We propose an initiative using healthcare claims data to assess the ability of nonrandomized RWE to provide results that are comparable with those from randomized controlled trials (RCT s). We selected 40 RCT s, and we estimate that approximately 30 attempted replications will be completed after feasibility analyses. We designed an implementation process to ensure that each attempted replication is consistent, transparent, and reproducible. This initiative is the first to systematically evaluate the ability of nonrandomized RWE to replicate multiple RCT s using a structured process. Results from this study should provide insight on the strengths and limitations of using nonrandomized RWE from claims for regulatory decision making.
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An advanced methodological approach was applied using the RCT-DUPLICATE design, data, and analytics framework to emulate key aspects of randomized studies.
“Second, an advanced methodological approach was applied using the RCT-DUPLICATE design, data, and analytics framework to emulate key aspects of randomized studies.33,63”
From Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction (2025) · cites this paper as [33]
The database studies were on average 19-fold larger than the trials and showed strong concordance in prespecified agreement metrics.
“The database studies, which were on average 19-fold larger than the trials, showed strong concordance in prespecified agreement metrices.33”
From Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction (2025) · cites this paper as [33]
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“Furthermore, many of the trials that were not found to be replicable given our self-imposed data constraints relied on laboratory values that are not measured in claims but are measured well in other RWD sources, such as EHRs.(38) A major barrier to greater reliance on RWE has been concerns about the validity of nonra…”
When and how can real world data analyses substitute for randomized controlled trials?
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Cited by
Sorted by citations
Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction
Krüger, N., Schneeweiss, S., Fuse, K., Matseyko, S., Sreedhara, S. K., Hahn, G., Schunkert, H., & Wang, S. V. (2025) · JAMA · doi:10.1001/jama.2025.14092 · Cited by 66
Digital Health COVID-19 Impact Assessment: Lessons Learned and Compelling Needs
Microsoft, Lee, P., Abernethy, A., Verily, Shaywitz, D., HealthTech, A., Gundlapalli, A., Prevention, U. S. C. F. D. C. A., Weinstein, J., Healthcare, M., et al. (2022) · NAM Perspectives · doi:10.31478/202201c · Cited by 49
Using Aggregate Patient Data at the Bedside via an On-Demand Consultation Service
Callahan, A., Gombar, S., Cahan, E. M., Jung, K., Steinberg, E., Polony, V., Morse, K., Tibshirani, R., Hastie, T., Harrington, R., et al. (2021) · NEJM Catalyst · doi:10.1056/cat.21.0224 · Cited by 24
Metadata
- Authors
- Franklin, J. M., Pawar, A., Martin, D., Glynn, R. J., Levenson, M., Temple, R., & Schneeweiss, S.
- Affiliations
- Division of Pharmacoepidemiology and Pharmacoeconomics Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA
- Office of Medical Policy Center for Drug Evaluation and Research US Food and Drug Administration Silver Spring Maryland USA
- Division of Biometrics VII Office of Biostatistics Center for Drug Evaluation and Research US Food and Drug Administration Silver Spring Maryland USA
- Office of Drug Evaluation I Office of New Drugs Center for Drug Evaluation and Research US Food and Drug Administration Silver Spring Maryland USA
- Venue
- Clinical Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2019-10-25
- Volume
- 107
- Issue
- 4
- Pages
- 817-826
- ISSN
- 0009-9236
- 1532-6535
- Cited by
- 119
- References
- 8
- Language
- en
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