Literature

Curbside Consults Podcast


Published August 22, 2019

Although randomized controlled trials get much of the attention in journal club, observational studies allow researchers to ask questions that may not be possible with RCTs. In this episode of Curbside Consults, we discuss the strengths and limitations of large observational studies and how to critically appraise them.

 

0:05 – Introductions
0:31 – Introduction of Zhu et al. Initial Opioid Prescriptions among U.S. Commercially Insured Patients, 2012–2017 and observational studies
1:22 – Why would a researcher want to design an observational study?
2:23 – Observational studies to assess exposures that cannot be assigned randomly
3:01 – Observational studies to assess national and societal trends
3:42 – Lack of randomization and bias in observational studies
4:25 – Sources of bias in observational studies
6:10 – Confounding variables in observational studies and lack of randomization
7:14 – Can you make a conclusion from an observational study?
7:30 – Discussion of the strengths and limitations of Zhu et al. Initial Opioid Prescriptions among U.S. Commercially Insured Patients, 2012–2017.
8:54 – Discussion of limitations of other observational studies
9:16 – Observational studies as hypothesis generators
9:39 – Approach to critically appraising observational studies

Resources and articles discussed in the episode:

1. Zhu et al. Initial Opioid Prescriptions among U.S. Commercially Insured Patients, 2012–2017. N Engl J Med 2019.
2. Di et al. Air Pollution and Mortality in the Medicare Population. N Engl J Med 2017.
3. Stern et al. Tau Positron-Emission Tomography in Former National Football League Players. N Engl J Med 2019.

The Curbside Consults series complements the foundational information in Rotation Prep by taking a deep dive into key clinical topics with expert clinicians and educators. These podcasts explore and critique the evidence behind clinical practice and break down statistical concepts for the busy clinical trainee.

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David Harrington is Emeritus Professor of Biostatistics and Statistics at Harvard T.H. Chan School of Public Health
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Angela Castellanos is a general pediatrician and was a 2018-2019 editorial fellow at the NEJM.
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