Composite End Points and Competing Risks Analysis

This article provides a detailed overview of using composite outcomes in clinical trials, particularly in cardiovascular and thoracic surgery. The main takeaways include the advantages of composite endpoints in increasing statistical power by combining multiple relevant outcomes, which can reduce sample size and improve trial feasibility. However, the authors also highlight key issues such as the potential for bias, the halo effect, and the importance of carefully selecting and interpreting composite outcomes. They emphasize the necessity of analyzing individual components within a composite to avoid misleading conclusions about treatment efficacy. The article also discusses the win ratio approach, a method that prioritizes clinically important outcomes when evaluating composite endpoints. Understanding the nuances of this statistical method is crucial for interpreting trial results and optimizing patient care.