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Reporting of surrogate endpoints in randomised controlled trial protocols (SPIRIT-Surrogate): extension checklist with explanation and elaboration

Abstract:
Randomised controlled trials often use surrogate endpoints to substitute for a target outcome (an outcome of direct interest and relevance to trial participants, clinicians, and other stakeholders—eg, all cause mortality) to improve efficiency (through shortened duration of follow-up, reduced sample size, and lower research costs), and for ethical or practical reasons. However, their use has a fundamental limitation in terms of uncertainty of the intervention effect on the target outcome and limited information on potential intervention harms. There have been increasing calls for improved reporting of trial protocols that use surrogate endpoints. This report presents the SPIRIT-Surrogate, an extension of the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) checklist, a consensus driven reporting guideline designed for trial protocols using surrogate endpoints as the primary outcome(s). The SPIRIT-Surrogate extension includes nine items modified from the SPIRIT 2013 checklist. The guideline provides examples and explanations for each item. We recommend that all stakeholders (including trial investigators and sponsors, research ethics reviewers, funders, journal editors, and peer reviewers) use this extension in reporting trial protocols that use surrogate endpoints. Its use will allow for improved design of such trials, improved transparency, and interpretation of findings when trials are completed, and ultimately reduced research waste.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/bmj-2023-078525

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Role:
Author
ORCID:
0000-0001-6276-926X


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Funder identifier:
https://ror.org/054225q67
Grant:
27294


Publisher:
BMJ Publishing Group
Journal:
British Medical Journal More from this journal
Volume:
386
Article number:
e078525
Place of publication:
England
Publication date:
2024-07-09
Acceptance date:
2024-04-30
DOI:
EISSN:
0959-8138
ISSN:
1759-2151
Pmid:
38981624


Language:
English
Keywords:
Pubs id:
2015543
Local pid:
pubs:2015543
Deposit date:
2025-03-17
ARK identifier:

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