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  "path": "/t/thinking-clearly-about-association-studies-risk-factors-and-causal-salad-included/28679#post_15",
  "publishedAt": "2026-04-02T15:01:22.000Z",
  "site": "https://discourse.datamethods.org",
  "textContent": "Advocate here. Agree that there are many examples of the misuse of associations in observational studies that mislead and even harm patients.\n\nOn the other hand, even if not commonly applied, the natural history of the disease changes the degree of inference we can have when an intervention is associated with a good outcome. High-quality natural history data can sometimes replace a placebo group in clinical trials. If the natural course is well-documented and severe, a treated group showing better outcomes can provide a statistically valid inference of efficacy. An example: Tazverik received accelerated approval in 2020 for Epithelioid Sarcoma. Researchers established an external control arm to track the natural history of patients on standard therapies, which helped prove the drug’s benefit in this rare, aggressive cancer. This being the rationale for FDA accelerated approvals.",
  "title": "Thinking Clearly about Association Studies (Risk Factors and Causal Salad included)"
}