Composite endpoints in clinical trials

Ignacio Ferreira-González, Pablo Alonso-Coello, Ivan Solà, Valeria Pacheco-Huergo, Antònia Domingo-Salvany, Jordi Alonso, Víctor Montori, Gaietà Permanyer-Miralda

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations


Composite endpoints are often used in clinical trials, especially in the cardiovascular area. Decreases in sample size requirements, ability to assess the net effect of an intervention and to avoid bias in presence of competing risk are the most cited advantages for their use. However, there is a risk of misinterpretation when heterogeneity among components with respect to either importance, number of events, or magnitude of treatment effect exist. In the following review we present a conceptual discussion about the rationale and interpretation of such variables. Also, a user's friendly guide to interpret the results of clinical trials based on composite endpoints is presented. We also present an empirical study that provides evidence of the use of misleading composite endpoints in cardiovascular clinical trials.

Original languageEnglish (US)
Pages (from-to)283-290
Number of pages8
JournalRevista Espanola de Cardiologia
Issue number3
StatePublished - Mar 2008


  • Clinical trials
  • Composite endpoints
  • Heterogeneity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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