Randomised controlled trials (RCTs) are challenging to conduct in rural areas, however, a new Griffith University study examined how high-quality research could be conducted when RCTs were not possible.
Dr Tanvir Kapoor from Griffith’s School of Medicine and Dentistry said rural areas posed challenges due to small populations, limited infrastructure, and workforce constraints.
“But RCTs are considered the gold standard in medical research, so it is imperative we find a way to include rural communities who are often underrepresented in research and health policies, which often reflect evidence generated in metropolitan settings,” Dr Kapoor said.
“A method known as ‘target trial emulation’ offers a rigorous and practical alternative as it involves using data which has already been collected during routine care.”
Researchers first defined what an ideal RCT would entail then replicated that design using real-world data.
This approach could produce robust and practical evidence without the cost, delay or logistical challenges of running a traditional trial, when it otherwise might be unfeasible.
Dr Kapoor said the approach would allow rural health innovations such as telehealth, workforce initiatives, and point-of-care diagnostics, to be researched quickly and rigorously.
“It ensures policies and funding decisions are informed by evidence generated in rural settings, leading to more equitable and effective healthcare,” he said.
“This work provides a pathway for embedding research into everyday clinical practice.
“By leveraging routinely collected data, it supports the development of learning health systems which generate timely, high-quality evidence to improve care and reduce health inequities in rural and remote communities.”
The paper ‘Target trial emulation and the target guideline to advance rural and remote health research’ has been published in the Medical Journal of Australia .
The Medical Journal of Australia
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Target Trial Emulation and the TARGET Guideline to Advance Rural and Remote Health Research
14-May-2026