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Updated: Oct 6, 2025

The Joint Effect of Social Comparison and Social Distance on Evaluation of Intertemporal Choice Outcomes in Event-related Potential Studies
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Decision-making given surrogate outcomes.

J André Knottnerus1, Bart J Knottnerus2

  • 1Department of Family Practice, Maastricht University Medical Centre, Maastricht, The Netherlands.

Journal of Clinical Epidemiology
|January 18, 2022
PubMed
Summary
This summary is machine-generated.

This commentary addresses the use of surrogate endpoints in clinical research when patient-important outcomes take too long to measure. It offers guidance for ethical and evidence-based decision-making in intervention research.

Keywords:
BalanceCriteriaDecision makingEffectivenessEthicsKnowledge mosaicLong termMonitoringPatient perspectivePatient-important outcomePolicySurrogate outcomes

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Area of Science:

  • Clinical Trial Design and Methodology
  • Evidence-Based Medicine
  • Health Policy and Decision Making

Background:

  • Debate exists on using patient-important health outcomes versus surrogate endpoints in intervention research.
  • Uncertainty surrounds the requirements for scientific evidence supporting decisions based on surrogate endpoints.

Purpose of the Study:

  • To elaborate on dilemmas concerning the use of surrogate endpoints in clinical research.
  • To provide guidance for decision-making when direct evidence on patient-important outcomes is lacking.

Main Methods:

  • This is a commentary discussing ethical, methodological, and practical considerations.
  • Guidance is provided for assessing surrogate endpoints and managing uncertainty.

Main Results:

  • Reasons for using surrogate endpoints include lengthy time to observe patient outcomes, unsustainable experimental conditions, and strong evidence of efficacy.
  • Appropriate use involves assessing predictive value (using GRADE guidelines), ensuring transparency, updating knowledge, weighing values, and monitoring adjustments.

Conclusions:

  • Surrogate endpoints are crucial for interventions with long-term outcomes, presenting an ongoing challenge.
  • Balancing uncertainty with the urgency of decisions and involving stakeholders in setting criteria is essential.