Conventional trials can't detect heterogeneity in BP Tx effe
Conventional clinical trials are unable to detect clinically The researchers found that in base-case analysis, clinically important HTEs could explain the differences in outcomes between two trials of intensive BP treatment, with decreasing benefit with each additional agent (adding a second agent reduces cardiovascular disease risk, but adding a fourth agent had no benefit) and increasing harm at low BP. In sensitivity analyses, despite large samples, conventional treat-to-target trial designs had poor power to detect HTEs (<5 percent), and produced biased estimates. Despite small samples, a trial with sequential randomization to more intensive therapy achieved greater than 80 percent power and unbiased HTE estimates....