Christina Qian: Bringing Real-World Evidence into Everyday Health-Care Decisions
By: Houda Houbeish
For Christina Qian, research has always been about generating evidence that can make a meaningful difference in people's lives.
After completing a master's degree in epidemiology with a specialization in pharmacoepidemiology at McGill University, Qian built a career focused on understanding how treatments perform in real-world settings. Today, she serves as a director at Broadstreet HEOR, where she leads studies that use health administrative claims and electronic health record data to examine disease burden, treatment outcomes and the impact of medications in everyday clinical practice.
Her work has long centred on real-world data, but participating in the Health Data Research Network Canada (HDRN Canada) Pragmatic Trials Training Program introduced her to a different way of thinking about how that evidence can be generated and applied. The program trains researchers and highly qualified personnel to design and implement pragmatic clinical trials using routinely collected health data to improve health systems and patient care. She explains:
"We're always taught that randomized controlled trials are at the top of the evidence hierarchy. But real-world evidence doesn't always get the same recognition. Pragmatic trials can help bridge that gap."
Pragmatic Trials & Real-world Evidence
For Qian, whose work takes place primarily in the private sector, that lesson felt especially relevant.
"In the private sector, studies often need to be more pragmatic because we're always working with limited time or funding," she said. "That's why learning about pragmatic clinical trials has been really valuable."
Organizations like Broadstreet HEOR help generate evidence that supports decision-making across the health-care system. Through health outcomes research, post-market analysis and the use of routinely collected data, private-sector researchers contribute insights that help regulators, policymakers and health-care organizations understand how treatments perform beyond the highly controlled conditions of traditional clinical trials.
Although Qian entered the program with extensive experience in study design and data analysis, she said the training broadened her understanding of what it takes to successfully conduct a pragmatic clinical trial.
"I understood the analytical side of research," she said. "What surprised me was how many other components need to come together. There are ethical considerations, stakeholder engagement, implementation planning and operational challenges that all play a role in making a trial successful."
That broader perspective helped her see pragmatic trials not simply as another research method, but as a collaborative process that connects researchers, clinicians, patients and health systems.
As the use of routinely collected health data continues to grow across Canada, Qian believes pragmatic clinical trials offer a powerful opportunity to produce evidence that is both scientifically rigorous and directly relevant to patient care.
"At the end of the day, we want research to inform real decisions," she said. "Pragmatic trials help generate evidence that reflects what actually happens in practice, and that's incredibly valuable for improving health care."
For Qian, that ability to connect data, research and real-world decision-making is what makes pragmatic trials such an important part of the future of health research.
** The HDRN Canada pragmatic trials training program is coordinated and hosted by the Schulich School of Medicine & Dentistry and is an initiative by Health Data Research Network (HDRN) Canada. It has been funded with $3.48 million from the Canadian Institutes of Health Research (CIHR). Read more.
