Users' Guides to the Medical Literature
Guyatt G, Rennie D, Meade MO, Cook DJ
Part B Therapy
Chapter 11.4. Surrogate Outcomes
Heiner C. Bucher, Regina Kunz, Deborah J. Cook, Anne Holbrook, Gordon Guyatt
Returning to our scenario and the study we retrieved, the randomized trial of telmisartan vs...
Topics Discussed:
angiotensin-converting enzyme inhibitors, application of economic analysis (cost-effectiveness), diabetes mellitus, type 2, diabetic nephropathy, economic analysis (cost-effectiveness), enalapril, health outcomes, precision of effects, research outcome, surrogate outcomes, treatment effect
Excerpt:
"When considering results, we are interested not only in whether
an intervention alters a surrogate endpoint but
also in the magnitude, precision, and duration of the effect. If
an intervention results in large reductions in the surrogate
endpoint, if the 95% CIs around those large
reductions are narrow, and if the effect persists throughout a sufficiently
long period, our confidence that the target outcome will be
favorably affected increases. Positive effects that are smaller,
with wider CIs and shorter duration of follow-up,
leave us less confident...."
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