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CGMthrowawaytoday at 4:40 PM0 repliesview on HN

Yes. Even conceding every point made in this article, RCTs are still the gold standard. The article points out that RCTs are often impractical, expensive or ethically challenging. Well, so is the gold standard of anything.

OP suggests that alternative methods like target trial emulation, propensity scoring and double machine learning can be used to approximate the conditions of an RCT using existing data. In saying so he gives away the tell, which is that RCTs are the standard being aspired to.

Observational data may well be undervalued. But RCTs are still the gold standard.