Win Ratio: An Approach to Analyzing Composite Endpoints

In this series of posts, we’ll explore the “Win Ratio” methodology’s literature review and its application in clinical trials

The Win Ratio, introduced in 2012, analyzes composite endpoints based on clinical priorities [1]. It prioritizes clinically significant events by calculating the total number of winners divided by losers.

Key Features of the Win Ratio

• Considers relative priorities of individual components in composite endpoints.
• Combines qualitative and quantitative outcomes for a more informative analysis.
• Includes patient-centered outcomes, enhancing clinical relevance [2, 3].

Internal Implementation and Interpretation

Patients in treatment and control groups are paired based on risk profiles, and the Win Ratio is calculated for each pair. Ratios greater than 1 indicate a higher likelihood of favorable outcomes in the treatment group [1].

Implementation using SAS and R

Researchers use statistical frameworks for “time to event” data, testing union hypotheses for hazard rates [4]. SAS and R facilitate straightforward implementation [5, 10].

Real Studies with Protocols and SAPs

The Win Ratio has been applied successfully in cardiovascular trials like NCT05411991 [11], NCT03888066 [12], and NCT01626079 [13], providing valuable insights for treatment comparisons.

References

1. Pocock, S. J., et al. (2012). https://lnkd.in/gwN7ciX8
2.  Pocock, S. J., et al. (2020). https://lnkd.in/gBdHDNzb
3. Ferreira, J. P., et al. (2021). https://lnkd.in/gnRt24Wy
4. Ipek, M., et al. (2014). https://lnkd.in/gDWSuVMP
5. Lachin, J. M. (2019). https://lnkd.in/g-QXKsXv
6. Lachin, J. M., et al. (2022). https://lnkd.in/gp8x9Cd8
7. Lachin, J. M., et al. (2019). https://lnkd.in/g3xnd_Wq
8. Bebu, I., et al. (2015). https://lnkd.in/g5AqEQse
9. Bebu, I., et al. (2015). https://lnkd.in/g9cUvrcE
10. WinRatio package for R (Version 1.0.0) [Software]. https://lnkd.in/gcgmtxqF
11. clinicaltrials.gov; NCT05411991. https://lnkd.in/gxqe5BVW
12.  clinicaltrials.gov; NCT03888066. https://lnkd.in/gvbtNqyP
13. clinicaltrials.gov; (n.d.). NCT01626079. https://lnkd.in/gn_FyQde