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Keywords:

  • comparative effectiveness;
  • randomized trials;
  • observational studies

Comparative effectiveness research represents the kind of research that arguably more directly affects clinical practice and policy. It includes observational studies, clinical trials, and systematic syntheses of existing literature. In this commentary, I argue for the ongoing and critical role of randomization in comparative effectiveness, noting the key differences between practical and explanatory trials. Copyright © 2012 John Wiley & Sons, Ltd.