自然实验在中医药疗效评价中的优势、挑战及实施路径OA

A natural experiment is a causal inference study design grounded in real-world research.Its core concept is to use quasi-random variation in exposure generated by external factors to evaluate the effects of interventions or exposures on outcomes.It is particularly suitable for research settings in which randomized controlled trials(RCTs)are infeasible or ethically constrained,and it combines causal inference capacity with relatively strong external validity.This article provides an overview of the definition,key features,and current application status of natural experiments,and proposes the application scenarios for applying natural experiment strategies to the evaluation of therapeutic effects in traditional Chinese medicine(TCM),including policy implementation or policy change evaluation,assessment of variations in clinical practice within hospitals,and evaluation of differences in resource allocation across regions or in-stitutions.The design pathway includes starting from clinical or policy-related TCM questions,systematically collecting relevant data,performing statistical modeling and effect estimation,and interpreting effect estimates in the context of clinical practice.It further analyzes the advantages and challenges of using natural experiments in TCM.