Clinical trials are vital for advancing medical knowledge, but the accurate reporting of surrogate endpoints has been an ongoing challenge. To address this, researchers have developed an extension to the CONSORT guidelines—aimed at improving the quality of reporting in randomized controlled trials (RCTs) when surrogate outcomes are involved.
“Surrogate endpoints, though invaluable, have often led to confusion in trial reporting,” the authors stated. This extension checklist, named CONSORT-Surrogate, is designed to provide clearer guidance and help researchers navigate the complexities of reporting these endpoints more transparently.
Why Are Surrogate Endpoints Important?
Surrogate endpoints serve as substitute markers for real clinical outcomes. They allow trials to be shorter or require fewer participants, but their reliability can sometimes be questionable. “While surrogate endpoints are efficient, their improper use can mislead healthcare professionals and policy makers,” the authors emphasized.
The new guidelines encourage researchers to provide explicit justifications for using surrogate endpoints and ensure that their potential limitations are clearly addressed. The checklist also covers recommendations on reporting how surrogate endpoints are validated and interpreted.
Application and Development of the Checklist
The development of this checklist involved a rigorous process, including Delphi surveys and pilot testing with various stakeholders in the medical community. “We sought input from clinical researchers, statisticians, and patients to ensure this tool addresses the broad range of challenges in surrogate endpoint reporting,” noted one of the leading researchers.
These efforts resulted in a structured and comprehensive checklist that improves both the transparency and utility of RCTs using surrogate outcomes. The checklist has been designed to fit seamlessly into the existing CONSORT framework.
Enhancing Research Reliability
The checklist serves as an essential tool for journals, peer reviewers, and research institutions. By enhancing transparency, it is hoped that the use of surrogate endpoints will become more reliable and better understood by those interpreting RCT findings. “With better reporting, the medical community will be able to make more informed decisions based on RCTs that use surrogate outcomes,” the researchers explained.
This tool also helps to mitigate risks associated with over-reliance on surrogate endpoints, which in the past have sometimes led to misleading conclusions. The CONSORT-Surrogate checklist could mark a pivotal shift in how such data is utilized in healthcare.
By adopting these guidelines, the broader healthcare community stands to benefit from more reliable and actionable insights gleaned from clinical trials. Researchers believe that improving surrogate endpoint reporting will ultimately lead to better healthcare outcomes and enhanced patient safety.
Citation:
Manyara AM, Butcher NJ, Bujkiewicz S, Chan A-W, Collins GS, Dawoud D, Offringa M, Ouwens M, Ross JS, Davies P, Stewart D, Weir CJ, Young AE, Blazeby J, Taylor RS, Ciani O. Reporting of surrogate endpoints in randomised controlled trial reports (CONSORT-Surrogate): extension checklist with explanation and elaboration. BMJ. 2023;386.
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