Evidence map›Paper›PMID 40697879›Full record

ArticleASIDE internal medicine2025

TriNetX and Real-World Evidence: A Critical Review of Its Strengths, Limitations, and Bias Considerations in Clinical Research.

Mahmoud Nassar, Hazem Abosheaishaa, Khaled Elfert, Azizullah Beran, Abdellatif Ismail, Mouhand Mohamed, Anoop Misra, Muhammed Amir Essibayi, David J Altschul, Ahmed Y Azzam

Abstract read
In one paragraph

Article in ASIDE internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed.

  1. Article
  2. Cardioprotective effects of Sodium-Glucose cotransporter-2 inhibitors in patients undergoing ventricular tachycardia (VT) ablation: a propensity-matched cohort study.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026
    Article
  3. Portal Vein Thrombosis Risk in Cirrhotic Patients With Portal Hypertension on Beta-Blockers: A Multi-Institutional Cohort Study.Liver international : official journal of the International Association for the Study of the Liver · 2026
    Article
  4. Gabapentin and cognitive impairment after traumatic brain injury: A multinational cohort of 49,925 patients.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026
    Article
  5. Article
  6. Article
  7. Observational
  8. Observational
  9. Article
  10. Review
  11. Observational
  12. Article
  13. Article
  14. Article
  15. Article
  16. Cardiorenal outcomes of weight loss interventions in people with CKD and type 2 diabetes.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mahmoud NassarDepartment of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Hazem AbosheaishaaInternal Medicine Department, Icahn School of Medicine at Mount Sinai, NYC H+H Queens, New York, NY, USA.
Khaled ElfertDivision of Gastroenterology, West Virginia University School of Medicine, Morgantown, WV, USA.
Azizullah BeranDivision of Gastroenterology and Hepatology, Indiana University, Indianapolis, IN, USA.
Abdellatif IsmailDepartment of Internal Medicine, University of Maryland Medical Center Midtown, Baltimore, MD, USA.
Mouhand MohamedDivision of Gastroenterology and Hepatology, May Clinic, Rochester, MN, USA.
Anoop MisraNational Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, Delhi, India.
Muhammed Amir EssibayiDepartment of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
David J AltschulDepartment of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Ahmed Y AzzamMontefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Funding

Einstein-Montefiore Clinical and Translational Science Award HubUM1TR004400 · NCATS · ALBERT EINSTEIN COLLEGE OF MEDICINE · PI Jessica Kahn, Mimi Y Kim · 2023 to 2026
$17.3M
NCATS NIH HHS UM1 TR004400
6 · The paper itself

Abstract

Introduction: The increasing utilization of real-world data platforms in medical research necessitates a comprehensive understanding of their methodological strengths and limitations. TriNetX has emerged as a significant platform for exploring large healthcare datasets. This review aims to critically evaluate the methodological framework and limitations of TriNetX, assess the impact of electronic health record coding accuracy on data reliability, and analyze the platform's capacity for generating generalizable real-world evidence in clinical research. Methods: We conducted a comprehensive review examining TriNetX's data architecture, quality metrics, and research applications, focusing on data integrity, platform architecture, and the external validity of research findings. Results: The analysis reveals significant methodological considerations. TriNetX's reliance on retrospective data introduces biases such as selection bias and confounding variables. The coding accuracy of electronic health records, which have not been independently validated, is a critical determinant of data reliability. The demographic representation is limited, affecting the generalizability of results. Discussion: Despite its extensive use, TriNetX's effective utilization requires careful consideration of its inherent limitations. The platform's data, predominantly from insured populations in academic and acute care settings, may not fully represent broader demographic groups. Addressing these methodological constraints is crucial for enhancing the reliability and applicability of research findings derived from TriNetX. Conclusions: TriNetX is a valuable resource for healthcare research. However, its limitations must be acknowledged, and future research should focus on standardizing data collection and enhancing data validation processes to mitigate platform-specific biases and improve the quality and applicability of the findings.

Indexed as

Clinical ResearchData QualityReal-World EvidenceResearch MethodologyTriNetX

Identifiers

PMID40697879
PMCPMC12282508

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.