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Can the Learning Health Care System Be Educated With Observational Data?

Can the Learning Health Care System Be Educated With Observational Data? Opinion Can the Learning Health Care System Be Educated VIEWPOINT With Observational Data? Given the complexity of medical decision making and amined do not seem to be predictive of concordance. Issa J. Dahabreh, MD, MS the myriad questions that arise during the care of indi- Choices in the design and analysis of observational Center for Evidence- viduals, an expectation that every causal question be ad- studies may be related to some of the more extreme Based Medicine, School dressed with a randomized clinical trial (RCT) is not real- differences observed, but this cannot be established of Public Health, Brown istic. Nevertheless, large administrative databases linked definitively using summary data. Thus, this body of University, Providence, Rhode Island; and with electronic health records, coupled with new statis- empirical evidence might be summarized quite simply: Department of Health tical methods for extracting causal information from raw observational studies are “usually right but sometimes Services, Policy, and data, can complement clinical trial evidence, enabling a wrong,” and there is no way of knowing when observa- Practice, School of “learning health care system.” Yet despite continued ad- tional study results are reliable. Without a better method Public Health, Brown University, Providence, vancesinepidemiologicalandstatisticalmethodsandthe of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Can the Learning Health Care System Be Educated With Observational Data?

JAMA , Volume 312 (2) – Jul 9, 2014

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Publisher
American Medical Association
Copyright
Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2014.4364
pmid
25005647
Publisher site
See Article on Publisher Site

Abstract

Opinion Can the Learning Health Care System Be Educated VIEWPOINT With Observational Data? Given the complexity of medical decision making and amined do not seem to be predictive of concordance. Issa J. Dahabreh, MD, MS the myriad questions that arise during the care of indi- Choices in the design and analysis of observational Center for Evidence- viduals, an expectation that every causal question be ad- studies may be related to some of the more extreme Based Medicine, School dressed with a randomized clinical trial (RCT) is not real- differences observed, but this cannot be established of Public Health, Brown istic. Nevertheless, large administrative databases linked definitively using summary data. Thus, this body of University, Providence, Rhode Island; and with electronic health records, coupled with new statis- empirical evidence might be summarized quite simply: Department of Health tical methods for extracting causal information from raw observational studies are “usually right but sometimes Services, Policy, and data, can complement clinical trial evidence, enabling a wrong,” and there is no way of knowing when observa- Practice, School of “learning health care system.” Yet despite continued ad- tional study results are reliable. Without a better method Public Health, Brown University, Providence, vancesinepidemiologicalandstatisticalmethodsandthe of

Journal

JAMAAmerican Medical Association

Published: Jul 9, 2014

References