{
  "abstract": "Clinical practice guidelines and healthcare policies increasingly leverage real-world data, often retrieved from electronic healthcare records (EHRs), to optimise disease prevention, diagnosis and management. 1 Traditionally, randomised controlled trials (RCTs) have been regarded as the gold standard for establishing causal relationships between interventions and outcomes, primarily due to their control over confounding factors. However, RCTs face what has been called the clinical trial paradox wherein their strict inclusion criteria and tightly controlled conditions improve internal validity but reduce generalisability to routine care settings.2 3 It is well known that clinical trial populations exclude people with complex morbidity.4 5 Additionally, different research designs answer different research questions and RCTs are not always fit for purpose to answer many important clinical questions. While strict criteria and conduct of RCTs indeed ensure internal validity on drug efficacy, external validity on drug effectiveness in general practice is often constrained, and ethical considerations sometimes preclude an ability to mimic all real-life conditions. Most RCTs are short in follow-up but also lose randomisation advantages after longer follow-up. Finally, high costs associated with measuring clinically relevant hard outcomes over prolonged timelines under strict conditions have spurred a growing interest in real-world evidence, derived from routine EHRs, registries and other observational data sources.6",
  "authors": [
    {
      "affiliations": [
        "Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands",
        "Department of Bioanalysis, Ghent University, Ghent, Belgium"
      ],
      "name": "Lies Lahousse"
    },
    {
      "affiliations": [
        "Department of Respiratory and Infectious Diseases, Copenhagen University Hospital - Bispebjerg, Copenhagen, Denmark"
      ],
      "name": "Kjell Erik Julius Håkansson"
    },
    {
      "affiliations": [
        "Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA"
      ],
      "name": "Aparna Balasubramanian"
    },
    {
      "affiliations": [
        "Department of Clinical Pharmacy & Pharmacology, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands",
        "Medication Adherence Expertise Center of the northern Netherlands (MAECON), Groningen"
      ],
      "name": "Job F M van Boven"
    },
    {
      "affiliations": [
        "Division of Respirology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"
      ],
      "name": "Andrea S Gershon"
    },
    {
      "affiliations": [
        "Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA"
      ],
      "name": "Chad H Hochberg"
    },
    {
      "affiliations": [
        "Respiratory Medicine, Ghent University Hospital, Ghent, Belgium"
      ],
      "name": "Guy F Joos"
    },
    {
      "affiliations": [
        "Medication Adherence Expertise Center of the northern Netherlands (MAECON), Groningen",
        "General Practitioners Research Institute, Groningen, The Netherlands",
        "Observational and Pragmatic Research Institute, Singapore"
      ],
      "name": "Janwillem W H Kocks"
    },
    {
      "affiliations": [
        "School of Health Sciences, University of Southampton, Southampton, UK"
      ],
      "name": "Adam Lewis"
    },
    {
      "affiliations": [
        "Institute for Respiratory Health, The University of Western Australia, Perth, Western Australia, Australia",
        "Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia",
        "School of Public Health, Imperial College London, London, England, UK"
      ],
      "name": "Vidya Navaratnam"
    },
    {
      "affiliations": [
        "School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"
      ],
      "name": "Fredrik Nyberg"
    },
    {
      "affiliations": [
        "Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada"
      ],
      "name": "Sanja Stanojevic"
    },
    {
      "affiliations": [
        "Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark"
      ],
      "name": "Mathias Therkelsen King"
    },
    {
      "affiliations": [
        "Asthma UK Centre for Applied Research, Centre for Medical Informatics, Usher Institute, The University of Edinburgh, Edinburgh, UK"
      ],
      "name": "Holly Tibble"
    },
    {
      "affiliations": [
        "Respiratory Medicine, Ghent University Hospital, Ghent, Belgium",
        "Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden",
        "COPD Center, Sahlgrenska University Hospital, Gothenburg, Sweden"
      ],
      "name": "Lowie Vanfleteren"
    },
    {
      "affiliations": [
        "Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark",
        "Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"
      ],
      "name": "Ulla Møller Weinreich"
    },
    {
      "affiliations": [
        "Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands"
      ],
      "name": "Katia Verhamme"
    },
    {
      "affiliations": [
        "School of Public Health, Imperial College London, London, England, UK"
      ],
      "name": "Jennifer K Quint"
    }
  ],
  "title": "Standardising terminology in routine electronic health records for respiratory endpoints: why we still can't agree",
  "uid": "e9e2a82f-73c6-54f6-bf38-f340b70acdd2"
}