The win ratio: a new approach to the analysis of composite endpoints in clinical trials based on clinical priorities

The conventional reporting of composite endpoints in clinical trials has an inherent limitation in that it emphasizes each patient's first event, which is often the outcome of lesser clinical importance. To overcome this problem, we introduce the concept of the win ratio for reporting composite endpoints. Patients in the new treatment and control groups are formed into matched pairs based on their risk profiles. Consider a primary composite endpoint, e.g. cardiovascular (CV) death and heart failure hospitalization (HF hosp) in heart failure trials. For each matched pair, the new treatment patient is labelled a 'winner' or a 'loser' depending on who had a CV death first. If that is not known, only then they are…

• P
  Pfizer
• A
  AstraZeneca
• EL
  Edwards Lifesciences
• UO
  University of Pittsburgh
• PP
  Pfizer Pharmaceuticals