Table 2.

Study designs in a pandemic, pros and cons

Study Design	Pros	Cons
RCT	•Gold standard design •Minimizes bias and confounding •Best at determining efficacy	•Time consuming and expensive making it difficult to perform in real time during a pandemic •Would need clinical equipoise
Emulation of target trial or RCT	•Can simulate RCT with preexisting observational data •Less time consuming and expensive •No ethical concerns	•May still have residual bias and confounding
Registry RCT	•RCT that is less time consuming and expensive •No ethical concerns	•Registries may lack necessary clinical information
Matched-pair analyses	•Allows for evaluation of treatment effect in an observational design	•May still have residual bias and confounding
Adaptive platform trial	•Allows evaluation of multiple interventions that can be added or dropped during the study •Is useful when mechanism of disease is not well understood •Requires fewer patients	•Requires multiple points of interim analysis