Randomize Everyone: Creating Valid Instrumental Variables for Learning Health Care Systems [Methods Study], New Hampshire, 2016-2022

Comparative effectiveness research, or CER, compares two or more treatments. In some CER studies, researchers use patient data from electronic health records, or EHRs, to compare treatments. But patient traits like age may affect doctors' and patients' choice of treatments, which can bias results. Using EHR systems to identify eligible patients and assign them to treatments by chance could improve results of CER studies that use EHR data.
In this study, the research team explored the views of patients, clinic staff, and clinicians, such as doctors or nurses, on doing CER studies in clinics. The team also tested software with a widely used EHR system. The software finds patients who qualify for a study. During a clinic visit, the software prompts doctors to invite patients to take part in the study. If patients agree, the software assigns patients by chance to a treatment.