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What's Behind DOOR Number 2? Recent Applications From Post-Hoc Analyses of Infectious Diseases Randomized Clinical
Jason M Pogue1, Ryan K Shields2
1Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA.
Open Forum Infectious Diseases
|June 24, 2026
Summary
Desirability of outcome ranking (DOOR) analyses offer a nuanced approach to evaluating infectious disease treatments. This editorial examines their impact versus traditional methods in recent pharmacotherapy literature.
Area of Science:
- Pharmacotherapy
- Infectious Diseases
- Clinical Trial Endpoints
Background:
- Traditional clinical trial endpoints in infectious diseases may not fully capture treatment benefits.
- There is a growing need for comprehensive outcome assessment in pharmacotherapy.
Purpose of the Study:
- To explore the impact and interpretation of desirability of outcome ranking (DOOR) analyses.
- To compare DOOR analyses with traditional endpoints in infectious diseases pharmacotherapy literature.
Main Methods:
- Literature review of recent infectious diseases pharmacotherapy studies.
- Analysis of studies employing desirability of outcome ranking (DOOR) analyses.
- Comparative assessment of DOOR versus traditional endpoints.
Main Results:
- DOOR analyses provide a more holistic view of treatment efficacy and safety.
- Interpretation of DOOR requires careful consideration of predefined outcome priorities.
- Comparison highlights potential discrepancies between DOOR and traditional endpoint conclusions.
Conclusions:
- DOOR analyses represent a valuable advancement in evaluating infectious disease pharmacotherapy.
- Understanding DOOR interpretation is crucial for evidence-based clinical decision-making.
- Further research should explore standardized application of DOOR in clinical trials.
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