Cardiovascular outcome trials of glucose-lowering strategies in type 2 diabetes-Authors' reply

摘要

We are delighted to see John Yudkin and colleagues sharing our vision1 of future trials using comprehensive electronic health records. Such systems will allow head-to-head comparisons of glucose-lowering drugs with longer follow-up periods at reduced costs. Some ongoing outcome trials have already used pragmatic designs, aiming to investigate the effectiveness of interventions in routine practice settings, with the intent of providing more generalisable results. However, approaches using electronic health record systems would enable clinical trials to be fully embedded within usual diabetes care. Several major UK and US initiatives (NIH Collaboratory, PCORnet) are developing powerful methods for this purpose.