Intended for healthcare professionals

Letters The idolatry of the surrogate

Surrogate end points: studying their benefits, taxonomy, and semantics

BMJ 2012; 344 doi: (Published 31 January 2012) Cite this as: BMJ 2012;344:e750
  1. Jeffrey K Aronson, clinical pharmacologist1
  1. 1University of Oxford, Department of Primary Health Care, Oxford OX1 2ET, UK
  1. jeffrey.aronson{at}

Yudkin and colleagues highlight some problems in using surrogate end points, largely in diabetes.1 There are three problems with their analysis.

Firstly, they do not clearly distinguish between surrogate end points for benefits and harms. As they suggest, harms rather than surrogates should be studied in trials. Although multiple end points should be studied when surrogates are used to assess …

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