CHOIcE Study Published: Rigorous Observational Research on ERCP in Elderly Patients

The CHOIcE study, led by WIRE Founding Director Dr. Zachary Smith, has been published, demonstrating that rigorous observational methodology can answer critical clinical questions when randomized trials aren't feasible. Using target trial emulation, the study compared ERCP versus observation in elderly patients with uncomplicated choledocholithiasis—a question that has long eluded definitive answers due to ethical and logistical barriers to randomization.

The study exemplifies WIRE's commitment to transparent, disciplined observational research. With a pre-registered protocol and pre-specified analyses published before any data were examined, the CHOIcE study applied the methodological rigor of a clinical trial to real-world data. This approach—grounded in transparency and scientific integrity—represents a core pillar of WIRE's research mission: generating trustworthy evidence that meaningfully informs care, even when traditional RCTs aren't an option. The answers were the answers.

Published in Clinical Gastroenterology and Hepatology: https://doi.org/10.1016/j.cgh.2026.02.010