Primary endpoints are the main result a trial is designed to measure, like tumour shrinkage. Secondary endpoints are other supportive outcomes, and composite endpoints combine several, like heart attack or death. A trial can succeed on these but be meaningless if the victory is too small—like a drug that shrinks a tumour by just 1% but causes severe side effects. I prescribed such a "successful" drug from a trial, and my patient gained only weeks, spending them in agony. That statistical win felt like a betrayal in my clinic.
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