“Most proposals to use EMR as a tool for comparative effectiveness research simply use the EMR as a large database for a traditional observational study. This possibility has received deserved attention, but has also been appropriately criticized, because such traditional observational studies are not nearly as reliable as RCTs in distinguishing true causal effects of drugs from non-causal associations. We propose a complementary way to use EMR that will retain some of the special advantages of RCTs at much lower cost and with fewer ethical problems. We call it Prompted Optional Randomization Trial, or PORTS, a design impossible in the days of paper charts but easily implemented [subscription required] using an EMR.”
“Blue Pill or Red Pill?
Down the Rabbit Hole of Comparative Effectiveness Research”