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The implementation of target trial emulation for causal inference: a scoping review
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The implementation of target trial emulation for causal inference: a scoping review
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The implementation of target trial emulation for causal inference: a scoping review
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Journal Article
The implementation of target trial emulation for causal inference: a scoping review
2023
Overview
We aim to investigate the implementation of Target Trial Emulation (TTE) for causal inference, involving research topics, frequently used strategies, and issues indicating the need for future improvements.
We performed a scoping review by following the Joanna Briggs Institute (JBI) guidance and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. A health research–focused librarian searched multiple medical databases, and two independent reviewers completed screening and extraction within covidence review management software.
Our search resulted in 1,240 papers, of which 96 papers were eligible for data extraction. Results show a significant increase in the use of TTE in 2018 and 2021. The study topics varied and focused primarily on cancer, cardiovascular and cerebrovascular diseases, and infectious diseases. However, not all papers specified well all three critical components for generating robust causal evidence: time-zero, random assignment simulation, and comparison strategy. Some common issues were observed from retrieved papers, and key limitations include residual confounding, limited generalizability, and a lack of reporting guidance that need to be improved.
Uneven adherence to the TTE framework exists, and future improvements are needed to progress applications using causal inference with observational data.
•Target trial emulation (TTE) was used in various observational studies, with the most frequent topic being cancer research (22.9%), followed by cardiovascular disease (15.6%).•Time-zero, random assignment emulation, and contrast strategies are critical for guaranteeing the quality of causal evidence generated from a TTE study, but not all papers using the TTE framework identified all three elements.•The unavailability of variables, which contributed to residual confounding, was the most frequently mentioned limitation of the research applying TTE to observational data.•There is no reporting guidance for TTE research, which poses a challenge in ensuring the implementation quality of TTE and the resulting causal evidence.
