#4-33E. Mastering Causal Inference: The TARGET Statement for Emulated Trials (JAMA, 2025)

How should we evaluate the efficacy of interventions when randomized controlled trials (RCTs) are not feasible or available in real-world clinical practice? When RCTs are impossible, researchers increasingly rely on observational data to emulate a hypothetical pragmatic RCT, known as a target trial, to assess causal effects. This study developed the TARGET statement, a consensus-based guideline featuring a 21-item checklist designed to improve the quality and transparency of reporting for observational studies using this target trial emulation approach. The most critical finding of this research is the establishment of standardized, consensus-driven reporting criteria for causal inference using observational data. However, when critically appraising studies using this framework, it is important to note that this guideline does not specifically address studies utilizing certain confounder control methods, such as instrumental variable estimation, meaning additional methodological reporting may still be required. For practicing physicians, this paper is highly relevant; it provides a powerful analytical tool to properly assess the validity and risk of bias in non-RCT evidence, empowering clinicians to confidently apply real-world data to daily clinical decision-making.

Citation: Cashin AG, et al. Transparent Reporting of Observational Studies Emulating a Target Trial—The TARGET Statement. JAMA. 2025. DOI: 10.1001/jama.2025.13350

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