All studies
Cardiology · EHR · England

Fan 2026

Heart failure

ITTSuperiorityAcademia4/5 disclosures
Comparisons
2
In the analysis
0
2 withheld
Target trials
2
Emulations reported
2
2 treatments

Comparisons

2 shown
Randomized trialEmulation
Outcome & target trialTrial vs emulationOn a shared scaleAgreement
Two-year all-cause mortality
vs Beta-blocker mortality RCT benchmark·HR·Efficacy
0.690.54–0.88
1.181.08–1.28
not pooledPartial alignment
Two-year all-cause mortality
vs DIG·HR·Efficacy
0.990.91–1.07
2.302.04–2.60
not pooledPartial alignment

Design and methods

Estimand
ITT
Design hypothesis
Superiority
Matching / weighting
Propensity-score matching, IPTW, and TMLE
Analysis method
Cox models and deep-learning estimators
Missing data
Multiple imputation
Covariates adjusted
39
DAG
No
QBA
No

Data and sample

Data type
EHR
Data sources
CPRD Aurum
Geography
England
Eligible sample
Beta blocker 417330; digoxin 1678203
Treated
Beta blocker 8076; digoxin 4377
Control
409254; 1673826
Emulations
2
Treatments compared
2

Transparency

4/5
Protocol
No pre-registration
Preprint
No preprint
Data availability
Available from CPRD subject to protocol approval
Code availability
https://github.com/Zhengxian-Fan/target-trial-emulation;…
Conflicts of interest
Declared: Industry
COI institutions
Relationships listed in the report
Funding
Declared: Public
Funders
British Heart Foundation FS/PhD/22/29321; Horizon Europe

The 0-5 count records which disclosures are present. It is not a quality score: a data link does not establish that the data are reusable.

Provenance

Review key
2026_Fan_HeartFailure
DOI
10.1038/s41467-026-74999-6
Affiliations
University of Oxford and UK academic collaborators
Sector
Academia
Target trials (study level)
Beta-blocker mortality benchmark; DIG
Registration
NCT00000476