Heart failure & cardiomyopathiesRandomised controlled trial
Analysis and Interpretation of a Hierarchical Outcome in a Small Pilot Randomized Trial: An Example in the CORTAHF Trial
- randomized 100-patient CORTAHF pilot trial
- post hoc hierarchical composite endpoints (HCE)
- generalized pairwise comparisons (GPC)
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
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
Summarised from the published abstract; every number is checked against it