Multiplicity Considerations in Clinical Trials
Abstract
Making multiple comparisons increases the likelihood that a chance association could be interpreted as causal. A number of statistical approaches can facilitate the precise interpretation of clinical trial results.
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When multiple comparisons are performed, the risk of false positives (type 1 error) is inflated.
“When multiple comparisons are performed (eg, multiple outcomes, time points, subpopulations, interim analyses), the risk of false positives (type 1 error) is inflated.”
From SPIRIT 2025 explanation and elaboration: updated guideline for protocols of randomised trials (2025) · cites this paper as [412]
Trials are often affected by multiplicity issues.
“Trials are often affected by multiplicity issues.411 412”
From SPIRIT 2025 explanation and elaboration: updated guideline for protocols of randomised trials (2025) · cites this paper as [412]
Guidance is available on key problems to consider for dealing with multiplicity.
“Although no standardised rules exist for dealing with multiplicity, guidance is available on key problems to consider.411 412”
From SPIRIT 2025 explanation and elaboration: updated guideline for protocols of randomised trials (2025) · cites this paper as [412]
No standardised rules exist for dealing with multiplicity.
“Although no standardised rules exist for dealing with multiplicity, guidance is available on key problems to consider.411 412”
From SPIRIT 2025 explanation and elaboration: updated guideline for protocols of randomised trials (2025) · cites this paper as [412]
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Optimal Multiple Testing and Design in Clinical Trials
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A Randomized Trial of Interval Likelihood Ratios for Clinical Decision-Making
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Multiplicity in clinical trial: An ignored concept
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Characteristics of Design and Statistical Analysis of NEI-funded Ophthalmic Clinical Trials
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- Authors
- Dmitrienko, A., & D’Agostino, R. B.
- Affiliations
- Boston University (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2018-05-31
- Volume
- 378
- Issue
- 22
- Pages
- 2115-2122
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2806596191
- Cited by
- 140
- References
- 30
- Citations by year
- 2026: 14 · 2025: 18 · 2024: 16 · 2023: 6 · 2022: 22 · 2021: 22 · 2020: 19 · 2019: 16 · 2018: 7
- FWCI
- 2.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods and Bayesian Inference
- Keywords
- multiplicity, multiple comparisons, clinical trials, statistical significance, false positives, causal inference
- MeSH terms
- Data Interpretation, Statistical, Humans, Research Design, Statistics as Topic, Causality, Clinical Trials, Phase III as Topic
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