Methodological Compromise in the EVIDENCE trial: Why a Non-Significant Result Does Not Mean Equivalence

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Main Authors: Albiña-Palmarola, Pablo, Henkes, Hans
Format: Recurso digital
Language:English
Published: Zenodo 2025
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author Albiña-Palmarola, Pablo
Henkes, Hans
author_facet Albiña-Palmarola, Pablo
Henkes, Hans
contents <p>The EVIDENCE trial compared flow diversion with coiling ± stenting for unruptured wide-neck intracranial aneurysms and reported no significant difference in the primary outcome. This commentary argues that such a result, in an underpowered randomized trial that was terminated early and whose primary hypothesis and endpoint handling were modified during the study, cannot be interpreted as evidence of equivalence. Instead, the findings should be regarded as inconclusive and insufficient to support practice-changing claims about the comparative safety and efficacy of flow diversion versus coiling.</p>
format Recurso digital
id zenodo_https___doi_org_10_5281_zenodo_17714558
institution Zenodo
language eng
publishDate 2025
publisher Zenodo
record_format zenodo
spellingShingle Methodological Compromise in the EVIDENCE trial: Why a Non-Significant Result Does Not Mean Equivalence
Albiña-Palmarola, Pablo
Henkes, Hans
Intracranial Aneurysm
Flow Diversion
Coiling
Clinical Trials as Topic
Endovascular Procedures
<p>The EVIDENCE trial compared flow diversion with coiling ± stenting for unruptured wide-neck intracranial aneurysms and reported no significant difference in the primary outcome. This commentary argues that such a result, in an underpowered randomized trial that was terminated early and whose primary hypothesis and endpoint handling were modified during the study, cannot be interpreted as evidence of equivalence. Instead, the findings should be regarded as inconclusive and insufficient to support practice-changing claims about the comparative safety and efficacy of flow diversion versus coiling.</p>
title Methodological Compromise in the EVIDENCE trial: Why a Non-Significant Result Does Not Mean Equivalence
topic Intracranial Aneurysm
Flow Diversion
Coiling
Clinical Trials as Topic
Endovascular Procedures
url https://doi.org/10.5281/zenodo.17714558