Both patients and clinicians want to understand what treatments work best when making complicated health-related decisions. The decisions may be supported by findings from randomized trials or, when these are not available, by the findings from observational data analyses that explicitly emulate a hypothetical randomized trial: the target trial.
Funded by PCORI Improving Methods, we designed and developed CERBOT (Comparative Effectiveness Research Based on Observational data to Emulate a Target Trial), a web-based tool that provides a structured standardized algorithm to define and emulate a target trial. The guiding principles for CERBOT development were established through a consensus process involving an 8-member advisory committee. CERBOT uses, as its basis, a conceptual framework that identifies observational analysis as a means to emulate a target trial. This could be achieved by explicitly formulating the protocol of the target trial, and addressing the feasibility of the conditions that must be met in order to emulate the target trial using observational data. The actual CERBOT website (cerbot.org) was developed through close collaboration with a web development firm using the most recent web-development technologies.
CERBOT included 5 modules used to design and operationalize a CER study by emulating a target trial. By synthesizing the information entered by the users, CERBOT provides specific recommendations for causal inference analytical methods based on each user’s individual research question. CERBOT also facilitates the formation and use of a multidisciplinary stakeholder research team. Through use of this ‘research circle’, it creates a communication platform for team members to collaboratively complete CERBOT modules by sharing ideas, comments, and conclusions.