Natural Experiments to Inform Clinical Practice.

Area of Science:

• Clinical research methodology
• Epidemiology
• Health policy analysis

Background:

• Natural experiments occur when individuals receive different interventions due to arbitrary reasons.
• They offer a valuable alternative to randomized clinical trials for causal inference in clinical research.
• Observational studies often suffer from bias, making natural experiments a compelling option.

Purpose of the Study:

• To provide an overview of natural experiments in clinical research.
• To discuss the potential of natural experiments for establishing cause-and-effect relationships.
• To outline applications, suitable situations, and challenges for using natural experiments in clinical settings.

Main Methods:

• Review of existing literature on natural experiments.
• Discussion of theoretical underpinnings for causal inference.
• Illustrative examples of clinical applications.

Main Results:

• Natural experiments can estimate causal impacts of treatments when RCTs are unavailable.
• They have become increasingly popular in health policy research.
• Specific applications to clinical questions demonstrate their utility.

Conclusions:

• Natural experiments hold significant potential for clinical research, particularly for causal inference.
• Despite their growing popularity, widespread application to specific clinical questions faces notable challenges.
• Further methodological development and careful application are needed to overcome these hurdles.