ArticleTrials2022
Multiple secondary outcome analyses: precise interpretation is important.
Article in Trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05844566 (Implementation of a Decision Support System and Its Effect on Early Optimisation of Lipid-Lowering Therapies in Patients With Acute Coronary Syndrome), which is not on this map. Cited by 37 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Implementation of a Decision Support System and Its Effect on Early Optimisation of Lipid-Lowering Therapies in Patients With Acute Coronary Syndrome: a Cluster Randomised Controlled Trial
Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The analysis and reporting of multiple outcomes in mental health trials: a methodological systematic review.BMC medical research methodology · 2024Pooled it
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- Multisite Randomized Trial of Inpatient Palliative Care Intervention for Patients Undergoing Hematopoietic Stem Cell Transplantation.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Trial
- Exercise without Weight Loss Prevents Seasonal Decline in Vitamin D Metabolites: The VitaDEx Randomized Controlled Trial.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Trial
- Low-Intensity Online Intervention for Mental Distress Among Help-Seeking Young People in Hong Kong: A Randomized Clinical Trial.JAMA network open · 2025Trial
- An SMS intervention to reduce caregiver's sugar-sweetened beverages: impacts on theoretical constructs and parenting practices from a randomized controlled trial in rural appalachia.Journal of nutritional science · 2025Trial
- Are there interindividual differences in the reactive hypoglycaemia response to breakfast? A replicate crossover trial.European journal of nutrition · 2024Trial
- A Randomized Controlled Cluster Trial of an Obesity Prevention Program for Children with Special Health Care Needs: Methods and Implications.Nutrients · 2024Trial
- Efficacy against pneumococcal carriage and the immunogenicity of reduced-dose (0 + 1 and 1 + 1) PCV10 and PCV13 schedules in Ho Chi Minh City, Viet Nam: a parallel, single-blind, randomised controlled trial.The Lancet. Infectious diseases · 2023Trial
- Serum neurofilament light and MRI predictors of cognitive decline in patients with secondary progressive multiple sclerosis: Analysis from the MS-STAT randomised controlled trial.Multiple sclerosis (Houndmills, Basingstoke, England) · 2022Trial
- Effectiveness of an integrated agriculture, nutrition-specific, and nutrition-sensitive program on child growth in Western Kenya: a cluster-randomized controlled trial.The American journal of clinical nutrition · 2022Trial
- Toward precision neuromodulation in ADHD: rTMS-evoked excitability as a biomarker and ccPAS as an alternative protocol.NeuroImage. Clinical · 2026Article
- When to Adjust for Multiple Testing: A Unifying Guiding Principle.Biometrical journal. Biometrische Zeitschrift · 2026Article
- A Brief Mindfulness Intervention for Pain Management in Fibromyalgia: A Single-arm Open-Label Study.Restorative neurology and neuroscience · 2026Article
- Randomised Evaluation of Sleep in Cognitive Impairment Trial (REST)-Protocol for a Feasibility Study of a Digital Cognitive Behavioural Therapy for Insomnia Intervention.International journal of environmental research and public health · 2026Article
- Immersive Virtual Reality Assessment in Multiple Sclerosis: Patient-Reported Experience and Correlates.Brain sciences · 2026Article
- Home-Based Immersive Virtual Reality to Improve Motor Performance in Children and Adolescents With Developmental Coordination Disorder: Crossover Study.JMIR serious games · 2026Article
- Pharmacogenetic-Guided Antidepressant Prescribing in Adolescents (PGx-GAP): Study Protocol for a Randomized Controlled Trial.Journal of personalized medicine · 2026Article
- The Benefits of a Digital Exercise Intervention for Older Adults: Findings From the Fittle Randomized Controlled Trial.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026Article
- Hospital-at-home versus hospital admission for acute care in Singapore: a prospective quasi-experimental study on cost, utilisation and clinical outcomes.BMC health services research · 2026Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Analysis of multiple secondary outcomes in a clinical trial leads to an increased probability of at least one false significant result among all secondary outcomes studied. In this paper, we question the notion that that if no multiplicity adjustment has been applied to multiple secondary outcome analyses in a clinical trial, then they must necessarily be regarded as exploratory. Instead, we argue that if individual secondary outcome results are interpreted carefully and precisely, there is no need to downgrade our interpretation to exploratory. This is because the probability of a false significant result for each comparison, the per-comparison wise error rate, does not increase with multiple testing. Strong effects on secondary outcomes should always be taken seriously and must not be dismissed purely on the basis of multiplicity concerns.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.