Design and Implementation of Observational Studies Emulating a Target Trial

In which clinical scenarios has target trial emulation (TTE) been applied, and how well do TTE studies adhere to key principles of target trial design and implementation?In this cross-sectional analysis of 237 TTE studies (2017-2023), 8 recurring clinical scenarios and substantial variation in design quality and methodologic implementation were identified. A structured framework and practical recommendations were proposed to address these gaps.These findings highlight the need to improve methodologic rigor in TTE, and the provided recommendations complement the Transparent Reporting of Observational Studies Emulating a Target Trial guideline by offering practical, scenario-based guidance for strengthening TTE methods.

Corresponding Authors: Jing Tan, PhD (tanjing84@outlook.com), and Xin Sun, PhD (sunxin@wchscu.cn), General Practice Medical Center, Chinese Evidence-Based Medicine Centre, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Sichuan, Chengdu 610041, China.

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