Heart failure & cardiomyopathies
Analysis and Interpretation of a Hierarchical Outcome in a Small Pilot Randomized Trial: An Example in the CORTAHF Trial
Authors' conclusion
Patients’ ranks can be derived from GPC and used to estimate stratified and covariate-adjusted win statistics as well as to visualize the treatment effect. Use of a well-constructed HCE in a small pilot trial should be considered; a positive signal may support further examination of the treatment. A full analysis can aid in interpretation.
Study context
- Population
- Patients with acute heart failure (AHF) receiving short-term corticosteroid therapyrandomized patients in the CORTAHF pilot trial
- Participants
- 100 patients
Methodological detailspost hoc hierarchical composite endpoints (HCE), generalized pairwise comparisons (GPC)
- Post hoc HCE
- Generalized pairwise comparisons (GPC)
Primary result
As reported in the abstract
Individual components of the HCE (90-day HF readmission, 30-day WHF adverse events, 30-day change in EQ-VAS)
- Beneficial prednisone effects suggested on 90-day HF readmission and 30-day WHF adverse events
- Little effect on 30-day change in EQ-VAS
Further findings
HCE (90-day death, 90-day HF readmission, 30-day worsening HF, 30-day change in EQ-VAS)
- Win ratio
- 1.82
- Win odds
- 1.71
- Ties remaining
- 10%
- Overall win difference
- 26.1%
- Both p<0.05
- HF readmission contributed most to the overall win difference
- Most comparisons were resolved at the last tier
Stratification and baseline covariate adjustment using patients' ranks
- Feasible, but did not substantially alter the estimated win odds
Original publication
Analysis and Interpretation of a Hierarchical Outcome in a Small Pilot Randomized Trial: An Example in the CORTAHF Trial. Eur Heart J Cardiovasc Pharmacother. Published 7 October 2026. doi:10. 1093/ ehjcvp/ pvag089
Composed by AI from the published abstract and checked against it. How Briefs are made →