Which design is more likely to reflect real-world practice?

• A. Prevalent User Design
• B. New User Design
• C. Randomized trial
• D. Case-control

Answer: (A)

When we want findings to apply to everyday clinical care, we look for designs that include patients as they are actually seen in practice. A prevalent user design does just that by studying people who are already on a therapy, at various points in their treatment, with differing durations and adherence patterns. This reflects the real-world mix of patients clinicians encounter, capturing how the drug is used and what outcomes occur in typical care settings. In contrast, enrolling only new users would miss the experience of long-standing patients, randomized trials impose strict protocols that don’t mirror routine practice, and case-control studies bring their own biases. So, the prevalent user approach offers the best alignment with real-world practice, even though it can introduce survivor bias since long-standing, tolerating users are more represented.