Process Guide for Inferential Studies Using Healthcare Data from Routine Clinical Practice to Evaluate Causal Effects of Drugs (PRINCIPLED): Considerations from the FDA Sentinel Innovation Center

This report proposes a stepwise process covering the range of considerations to systematically consider key choices for study design and data analysis for non-interventional studies with the central objective of fostering generation of reliable and reproducible evidence. These steps include (1) formulating a well defined causal question via specification of the target trial protocol; (2) describing the emulation of each component of the target trial protocol and identifying fit-for-purpose data; (3) assessing expected precision and conducting diagnostic evaluations; (4) developing a plan for robustness assessments including deterministic sensitivity analyses, quantitative bias analyses, and net bias evaluation; and (5) inferential analyses.