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Improving Power of the Win Ratio Analysis through Distance-based Weights
Md Rejuan Haque1,2, Madison Hyer2, Lai Wei1,2
1Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Statistics in Medicine
|April 28, 2026
Summary
This study introduces a new win ratio method for clinical trials, enhancing statistical power by incorporating covariate information. The proposed approach improves analysis of composite endpoints when covariates are linked to outcomes.
Area of Science:
- Biostatistics
- Clinical Trial Design
- Statistical Methods
Background:
- The win ratio method is popular for analyzing composite endpoints in clinical trials.
- Existing methods have limitations in incorporating covariate information.
- Prioritization of composite outcome components is a key feature of the win ratio.
Purpose of the Study:
- To extend the win ratio method by incorporating covariate information.
- To improve the statistical power of the win ratio when covariates are associated with outcomes.
- To develop a weighted win ratio approach based on covariate distances.
Main Methods:
- Developed a weighted win ratio method incorporating covariate values.
- Assigned weights to wins/losses based on the distance between compared pairs using covariates.
- Evaluated the method through detailed simulation studies and real data analyses.
Main Results:
- The proposed weighted win ratio method demonstrated increased power when covariates were associated with composite outcome components.
- Simulation studies confirmed the enhanced performance of the new method.
- The method performed comparably to the original win ratio when covariates lacked association with outcomes.
Conclusions:
- The covariate-weighted win ratio method is a valuable extension for analyzing composite endpoints.
- This approach offers improved statistical power in clinical trials where relevant covariates are available.
- The method provides a robust alternative for composite endpoint analysis, especially when covariates influence outcomes.
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