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Target trial emulation for comparative effectiveness research with observational data: Promise and challenges for
Paul J Christine1,2, Sara Lodi3, Heather E Hsu4
1Section of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
Abstract:
Medications for opioid use disorder (MOUD) increase retention in care and decrease mortality during active treatment; however, information about the comparative effectiveness of different forms of MOUD is sparse. Observational comparative effectiveness studies are subject to many types of bias; a robust framework to minimize bias would improve the quality of comparative effectiveness evidence. This paper discusses the use of target trial emulation as a framework to conduct comparative effectiveness studies of MOUD with administrative data. Using examples from our planned research project comparing buprenorphine-naloxone and extended-release naltrexone with respect to the rates of MOUD discontinuation, we provide a primer on the challenges and approaches to employing target trial emulation in the study of MOUD.
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