Methodologic discussions for using and interpreting composite endpoints are limited, but still identify major concerns - PubMed Methodologists have given limited attention to CEPs and their views are sometimes contradictory. Further work is needed to establish the role of CEPs in research and in guiding clinical practice.

#CompositeEndpoints frequently mislead by overestimating benefits: #death, #MyocardialInfarction (dominated), and #revascularization. Worse, add #stroke to these three and goes in opposite direction to revascularization and composite favors the wrong intervention!

pubmed.ncbi.nlm.nih.gov/17573977/

Problems with use of composite end points in cardiovascular trials: systematic review of randomised controlled trials - PubMed The use of composite end points in cardiovascular trials is frequently complicated by large gradients in importance to patients and in magnitude of the effect of treatment across component end points....

#CompositeEndpoints in #RCTs: big problem. #BMJ survey of use in #cardiovascular trials: they make results look more important than they are through impression of benefits in death when only real effect in much less important outcomes (e.g. stent placement)
pubmed.ncbi.nlm.nih.gov/17403713/