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Unlike Australia, a number of countries have well-established clinical registries and, for more than a decade, have developed the capability to undertake embedded randomised trials across a variety of clinical disciplines.36 A well-conducted scoping review identified 17 published trials using disease, procedure or health services registries.7 One of the early demonstrations of the registry randomised clinical trials (RRCTs) was the Thrombus Aspiration in ST-Elevation Myocardial Infarction (TASTE) rial tundertaken in the SWEDEHEART clinical registry demonstrating no benefit of thrombus aspiration prior to percutaneous coronary intervention for improving clinical outcomes.8 Heralded as the next disruptive technology for undertaking randomised trials,9 the SWEDEHEART registry has continued to perform a number of important comparative effectiveness trials and proposing international registry-based randomised trials