There is a lack of high-quality evidence underpinning many contemporary clinical practice guidelines embedded in the healthcare systems, leading to treatment uncertainty and practice variation in most medical disciplines. Comparative effectiveness trials (CETs) represent a diverse range of research that focuses on optimising health outcomes by comparing currently approved interventions to generate high-quality evidence to inform decision makers. Yet, despite their ability to produce real-world evidence that addresses the key priorities of patients and health systems, many implementation challenges exist within the healthcare environment. This manuscript aims to highlight common barriers to conducting CETs and describes potential solutions to normalise their conduct as part of a learning healthcare system.

中文翻译：

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将比较有效性试验标准化为临床实践

缺乏高质量的证据支持嵌入在医疗保健系统中的许多当代临床实践指南，导致大多数医学学科的治疗不确定性和实践差异。比较有效性试验 (CET) 代表了一系列不同的研究，这些研究侧重于通过比较当前批准的干预措施来优化健康结果，以生成高质量的证据来为决策者提供信息。然而，尽管他们能够产生现实世界的证据来解决患者和卫生系统的关键优先事项，但医疗保健环境中仍存在许多实施挑战。这份手稿旨在强调实施 CET 的常见障碍，并描述将其行为规范化的潜在解决方案，作为学习医疗保健系统的一部分。