‘Real-world’ observational studies in arrhythmia research: data sources, methodology, and interpretation. A position document from European Heart Rhythm Association (EHRA), endorsed by Heart Rhythm Society (HRS), Asia-Pacific HRS (APHRS), and Latin America HRS (LAHRS)

Author:

Torp-Pedersen Christian1ORCID,Goette Andreas2,Nielsen Peter Bronnum1,Potpara Tatjana34,Fauchier Laurent5,John Camm Alan6,Arbelo Elena789,Boriani Giuseppe10,Skjoeth Flemming11,Rumsfeld John12,Masoudi Frederick13,Guo Yutao14,Joung Boyoung15,Refaat Marwan M16,Kim Young-Hoon17,Albert Christine M18,Piccini Jonathan19,Avezum Alvaro20,Lip Gregory Y H2122,Gorenek Bulent23,Dagres Nikolaos24,Violi Francesco25,Du Xin26,Akao Masaharu27,Choi Eue-Keun28,Lopes Renato D29,Ozcan Evren Emin30,Lane Deirdre2122,Marin Francisco31,Gale Christopher Peter32,Vernooy Kevin33,Kudaiberdieva Gulmira3435,Kutyifa Valentina3637,Traykov Vassil B38,Guevara Carolina39,Chao Tze-Fan40,Al-Khatib Sana M41,

Affiliation:

1. Aalborg University, Health Science and Technology, Aalborg, Denmark

2. St. Vincenz-Krankenhaus Gmbh, Paderborn, Germany

3. School of Medicine, Belgrade University, Belgrade, Serbia

4. Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia

5. Service de Cardiologie, Centre Hospitalier Universitaire Trousseau et Université de Tours, Faculté de Médecine, Tours, France

6. St. George's, University of London, Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK

7. Arrhythmia Section, Cardiology Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain

8. IDIBAPS, Institut d’Investigació August Pi i Sunyer (IDIBAPS), Barcelona, Spain

9. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain

10. Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy

11. Aalborg University, Health Science and Technology, Aalborg, Denmark

12. University of Colorado School of Medicine, Aurora, CO, USA

13. Division of Cardiology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

14. Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of China

15. Cardiology Department, Yonsei University College of Medicine, Seoul, Republic of Korea

16. Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon

17. Cardiology Department, Korea University Medical Center, Seoul, Republic of Korea

18. Brigham and Women's Hospital, Boston, MA, USA

19. Duke Center for Atrial Fibrillation, Duke University Medical Center, Duke Clinical Research Institute, Durham, NC, USA

20. Dante Pazzanese Institute of Cardiology, Sao Paulo, Brazil

21. Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool Heart & Chest Hospital, Liverpool, UK

22. Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

23. Eskisehir Osmangazi University, Eskisehir, Turkey

24. Department of Electrophysiology, Heart Center Leipzig, Leipzig, Germany

25. Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Viale del Policlinico, 155 - 00162 Roma, Italy

26. Department of Cardiology, Anzhen Hospital, An Ding men wai, Anzhenli, 100029 Beijing, People's Republic of China

27. Department of Cardiology, National Hospital Organization Kyoto Medical Center, 1-1, Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto 612-8555, Japan

28. Seoul National University College of Medicine, Cardiovascular Center, Seoul National University Hospital, 101 Daehak-ro, Chongno-gu, Seoul 03080, Republic of Korea

29. Duke University Medical Center, Duke Clinical Research Institute, 200 Morris St., P.O. Box 17969, NC 27701, Durham, NC 27715, DUMC#: 3850

30. Department of Cardiology, Dokuz Eylul University, 35340 Balçova/İzmir, Turkey

31. Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, CIBERCV, University of Murcia, Murcia, Spain

32. University of Leeds, LICAMM, Medical Research Council Bioinformatics Centre, LICAMM, Worsley Building, LS2 9JT Leeds, UK

33. Department of Cardiology, Maastricht University Medical Center, PO BOX 5800, 6202 AZ Maastricht, Netherlands

34. Adana, Turkey Center for Postgraduate Education and Research, Bishkek, Kyrgyzstan

35. Kyrgyzstan Scientific Research Institute of Heart Surgery and Organ Transplantation, Bishkek, Kyrgyzstan

36. University of Rochester Medical Center, Rochester, NY, USA

37. Semmelweis University Heart Center, Budapest, Hungary

38. Department of Invasive Electrophysiology, Acibadem City Clinic Tokuda Hospital, Sofia, Bulgaria

39. Instituto Nacional Cardiovascular Incor, Jirón Coronel Zegarra 417, Jesús María 15072, Peru

40. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

41. Duke University Medical Center, Durham, NC 27715, USA

Abstract

Abstract The field of observational studies or “real world studies” is in rapid development with many new techniques introduced and increased understanding of traditional methods. For this reason the current paper provides an overview of current methods with focus on new techniques. Some highlights can be emphasized: We provide an overview of sources of data for observational studies. There is an overview of sources of bias and confounding. Next There is an overview of causal inference techniques that are increasingly used. The most commonly used techniques for statistical modelling are reviewed with focus on the important distinction of risk versus prediction. The final section provides examples of common problems with reporting observational data.

Publisher

Oxford University Press (OUP)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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