The target trial framework in global health research: barriers and opportunities

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This talk is by Anthony Matthews, Karolinska Institutet

A randomized trial is the best way to make casual inference when evaluating the effectiveness and safety of health interventions in global health research. Trials, however, are inherently expensive, unfeasible in many scenarios, and may encounter ethical issues; in these scenarios we must turn to analyses of observational data to learn what works. The target trial framework provides an organizing principle for the design of observational studies that can lead to clinically interpretable results and analytic approaches that can reduce common biases. In this talk I will give an introduction to the target trial framework for causal inference, describe its current place in global health research, and suggest some solutions for how to effectively incorporate its uptake. 

Additional educational resources:

  1. Hernán, M.A. & Robins, J.M. (2020). Causal Inference: What If?. Boca Raton: Chapman & Hall/CRC -https://www.hsph.harvard.edu/miguel-hernan/wp-content/uploads/sites/1268/2024/04/hernanrobins_WhatIf_26apr24.pdf 
  2. Hernán, M.A. and Robins, J.M. (2016). Using big data to emulate a target trial when a randomized trial is not available. American Journal of Epidemiology, 183(8):758-764 - https://academic.oup.com/aje/article-abstract/183/8/758/1739860?redirectedFrom=fulltext&login=false
  3. Matthews AA,  Danaei G,  Islam N,  Kurth T. Target trial emulation: applying principles of randomised trials to observational studies. BMJ. 2022. 378; e071108 - https://www.bmj.com/content/378/bmj-2022-071108
  4. Murray, E. J., Caniglia, E. C., & Petito, L. C. (2021). Causal survival analysis: A guide to estimating intention-to-treat and per-protocol effects from randomized clinical trials with non-adherence. Research Methods in Medicine & Health Sciences, 2(1), 39-49 - https://github.com/eleanormurray/CausalSurvivalAnalysisWorkshop
  5. Target trial emulation talk by Prof. Miguel Hernán- https://www.youtube.com/watch?v=mGyd9c8sXr8
  6. CAUSALab Methods Series talks - https://youtube.com/playlist?list=PLlPWrOkuvI8S6t00nMDYnwhGvvkYUwhJe&si=jHcSERTOZmdmi2cl

About Nordic Global Health Talks

Nordic Global Health Talks is a monthly webinar series about global health research at Nordic universities, hosted by the Nordic Network on Global Health. It is free and open to everyone interested in knowing more about Nordic global health research, education and collaborative projects.

Read more and find the programme here.