Miguel Hernan

1/

Problem: The best therapies for advanced pancreatic #cancer (Folfirinox, GN) haven't been compared in a head-to-head randomized trial due to cost and commercial barriers.

We emulated a #TargetTrial using observational data: Folfirinox is a bit better

https://www.sciencedirect.com/science/article/pii/S1047279722003088?dgcid=coauthor

Dec 28, 2022 at 5:40pmWeb
Show threadMiguel HernanDec 28, 2022

Because randomized trials are great only when they exist.

Without trials, high-quality observational data + explicit #TargetTrial emulation is our best chance to help

people make the treatment decisions they must make

until we convince companies/funders to pay for the trial.

Show threadFrank HarrellDec 29, 2022
@MiguelHernan But there are many cases where observational studies destroyed the perception of equipois and resulted in delayed or unsuccessful (recruiting-wise) randomized trials. Randomize early and often.
Show threadBenedicteCallanDec 28, 2022
@MiguelHernan
That curve is still brutal. Hate pancreatic cancer.