One of the most upvoted comments on my #ACR21 plenary was "Why are we still doing observational studies on risks of #steroidsinRA? Given unavoidable confounding, shouldn't we just focus on clinical trials?" I responded in-platform, but thought the topic called for a🧵also. 1/ First of all, clinical trials on this topic are very important, and, when well-designed, will almost always yield results more reliable than those of observational studies when powered to look at common, short-term steroid side effects. 2/