Program Schedule

The NIH Pragmatic Trials Collaboratory supports the design, conduct, and dissemination of large-scale embedded pragmatic clinical trials (ePCTs) that address significant public health challenges. The trials are embedded into routine care and frequently use digital solutions from the electronic health record (EHR) for aspects of trial conduct, such as electronic consent (eConsent), collection of patient-reported outcomes (PROs), and use of clinical decision support tools to identify patients and provide education. Through this work, the principal investigators (PIs) have identified health equity challenges, including: identifying subgroups that may be wholly or partially excluded from EHR-based recruitment, bias in the design of EHR-based interventions, data missingness or misrepresentation of under-represented research participants, and issues of generalizability. Based on our collective experience with pragmatic trials using data from EHR systems, this panel will share case examples and solutions to challenges of EHR-based pragmatic research, including recommendations to actively mitigate bias and promote health equity.