Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
In Reply: In response to Drs van Leth and Lange,
we do not wish to comment on the appropriateness or otherwise of surrogates
in clinical trials in HIV, or the confounding of efficacy and tolerability
measures discussed by them. However, time to treatment failure was one of
the examples we used to describe a situation in which use of a composite outcome
is appropriate, when there is a single underlying clinical occurrence (treatment
failure) that can occur in multiple ways.
Freemantle N, Calvert M, Wood J, Eastaugh J, Griffin C. Disseminating Health Care Innovation. JAMA. 2003;290(11):1456-1457. doi:10.1001/jama.290.11.1456-a