Abstract
textabstractObservational epidemiology is continually held to thestandard of randomized trials. A typical epidemiology article references previous trials in the introduction (or reasons why trials are not feasible) and, when possible, compares the results to previous trials in the discussion. When the results from an observational study and trial disagree, we nearly always begin by questioning the former. Curiously, the methods section of an observational study — an undeniably crucial part of an article — rarely references trial methods or designs. Explicit target trial emulation aims to remedy this.
Highlights
Target trials in the classroomMost important advances in epidemiologic methods in recent decades have been coupled with increased complexity both statistically and in the assumptions required for unbiased estimation
Observational epidemiology is continually held to the standard of randomized trials
It seems clear that trial emulation should be a core component to how causal inference gets taught in epidemiology curriculum
Summary
Most important advances in epidemiologic methods in recent decades have been coupled with increased complexity both statistically and in the assumptions required for unbiased estimation. In order to teach trial emulation to epidemiologists, introductory epidemiology courses require little augmentation. It seems clear that trial emulation should be a core component to how causal inference gets taught in epidemiology curriculum. Educators need to weigh whether the trial emulation merits displacing other core material in epidemiology courses; alternatively, it is possible that its inclusion streamlines or better conveys the fundamentals of observational epidemiology that are already taught in introductory classes and better connects those fundamentals to the statistical analyses taught in advanced classes. Educators who teach epidemiology to non-epidemiologists (e.g., policy-makers; medical researchers from other disciplines) may see their students’ comprehension improving, as trial emulation seems more readily accessible than teaching causal diagrams or counterfactual notation while still being able to convey the same foundational principles
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