Practical elements to consider when emulating a target trial

Viet-Thi Tran; Raphaël Porcher; Elodie Perrodeau; Sally Yaacoub; Isabelle Boutron; Philippe Ravaud

doi:10.1016/j.jclinepi.2026.112205

Practical elements to consider when emulating a target trial

J Clin Epidemiol. 2026 Feb 27:112205. doi: 10.1016/j.jclinepi.2026.112205. Online ahead of print.

Authors

Viet-Thi Tran¹, Raphaël Porcher², Elodie Perrodeau³, Sally Yaacoub⁴, Isabelle Boutron², Philippe Ravaud⁵

Affiliations

¹ Center for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, F-75004 Paris, France; Centre d'Epidemiologie clinique, AP-HP, Hôpital Hôtel Dieu, F-75004 Paris, France. Electronic address: thi.tran-viet@aphp.fr.
² Center for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, F-75004 Paris, France; Centre d'Epidemiologie clinique, AP-HP, Hôpital Hôtel Dieu, F-75004 Paris, France.
³ Centre d'Epidemiologie clinique, AP-HP, Hôpital Hôtel Dieu, F-75004 Paris, France.
⁴ Center for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, F-75004 Paris, France.
⁵ Center for Research in Epidemiology and Statistics (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, F-75004 Paris, France; Centre d'Epidemiologie clinique, AP-HP, Hôpital Hôtel Dieu, F-75004 Paris, France; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, United States of America.

PMID: 41765347
DOI: 10.1016/j.jclinepi.2026.112205

Abstract

When carefully designed and analyzed, target trial emulation, i.e., the analysis of observational data through the explicit emulation of the design components of randomized controlled trials (RCT), can provide causal inference on the effects of pharmacological and non-pharmacological interventions that are, on average, similar to those of RCTs. This article aims to clarify differences between RCTs and their emulations, and to provide key elements to consider when emulating a target trial, so as to help researchers plan these studies.