Distributed research networks and applications to pragmatic randomized trials

Abstract Large databases may improve study diversity and precision in epidemiologic and clinical studies, and make it feasible to study rare exposures and outcomes. In some circumstances, large single databases may be inadequate, leading to the need for multiple databases to address a study question. When multiple databases are needed, either centralized or distributed research networks (DRNs) can be used. Within the context of pragmatic randomized clinical trials (pRCTs), DRNs can facilitate study enrollment, data collection, analysis, and potentially increase the generalizability of study findings. This chapter provides an overview of DRNs and examples of how such networks are utilized for conducting pRCTs.