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Use of appropriate statistical methodology can allow for the synthesis of data collected as part of traditional clinical trials with real-world data

Tools, Methods of RCTs Can Be Adapted to Real-World Settings

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3 options described for applying approaches used in randomized controlled trials to real-world data
There have been 11 lung-related infant deaths after pregnant women in the Netherlands were given sildenafil (Viagra) to boost the growth of their babies while in the womb.

11 Infant Deaths Halt Trial of Sildenafil in Pregnant Women

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Aim of the trial was to improve blood flow to the placenta and promote fetal growth
Pivotal trials supporting U.S. Food and Drug Administration approvals granted Breakthrough Therapy designation often lack randomization

Trials Supporting FDA Approval of Breakthrough Drugs Examined

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Pivotal trials supporting these approvals often lack randomization, double-blinding, control groups
The quality of atrial fibrillation/atrial flutter trials is variable

Variation in Quality of Trials for Atrial Fibrillation, Flutter

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Most common trial endpoint is AF/AFL recurrence; rates of primary clinical endpoints are low
Many organizations are not meeting the trial registration and results reporting requirements clarified by "The Final Rule

Many Organizations Not Meeting Trial Reporting Requirements

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Only 19 percent of organizations use computer software to monitor compliance with Final Rule
The majority of caregivers of children with food allergy are willing to consider participation in clinical trials for food allergy immunotherapy

Most Parents Willing to Enroll Child in Food Allergen Trials

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Higher parental income only significant positive predictor of willingness to enroll child in trial
Trials to evaluate drugs or devices used to treat chronic medical conditions that are published early in the chain of evidence often show an exaggerated treatment effect compared with subsequent trials

Early Studies Often Show Exaggerated Treatment Effect

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Findings based on assessment of trials evaluating drugs, devices to treat chronic medical conditions
Almost half of clinical trials for prostate cancer use criteria that disproportionately exclude black men

Criteria for Prostate Cancer Trials Disproportionately Exclude Blacks

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Trials sponsored by academic investigators, cooperative groups more likely to use these criteria
Spin in biomedical literature (also referred to as "science hype") is prevalent

‘Science Spin’ Found Prevalent in Biomedical Literature

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Nature of spin varies, with highest variability in prevalence of spin seen in trials
Studies often fail to include information on outcomes by medication adherence in type 2 diabetes

Studies Often Fail to Include Info on T2DM Medication Adherence

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Relative risks of good versus poor adherence to meds reduced for all-cause mortality, hospitalization