{"doi":"10.1093/cid/ciaf188","title":"Subgroup Analyses in Randomized Trials of <i>Clostridioides difficile</i>–Associated Disease: Recurring Challenges With Analyzing Recurrence","abstract":"The trial comparing ridinilazole to vancomycin in treatment of symptomatic Clostridioides difficile-associated disease (CDAD) failed to demonstrate superiority of ridinilazole on sustained clinical response (SCR)-a combination of initial response with no recurrence.Yet a subgroup analysis claims benefit on disease recurrence prevention. 1 Analysis of secondary endpoints is challenging with failure on primary endpoints due to increased rate of false positive results from multiple hypothesis testing. 2 The recurrence analysis also highlights potential biases in postrandomization subgroups presented in several CDAD trials.Yusuf et al. define an improper subgroup as trial participants classified by factors measured after randomization. 3 Post-randomization subgroups are particularly prone to bias because their composition can be influenced by effects of interventions being tested, causing imbalances between groups on patient prognostic characteristics.Patients are no longer randomly distributed","journal":"Clinical Infectious Diseases","year":2025,"id":536092,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9513,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1221543,"name":"Shanan Immel","orcid":"0000-0002-5755-5264","position":1,"is_corresponding":false},{"id":1154459,"name":"Ian Drobish","orcid":"0000-0003-0317-9336","position":2,"is_corresponding":false},{"id":237092,"name":"John H. Powers","orcid":"0000-0002-5150-5119","position":3,"is_corresponding":false},{"id":1283332,"name":"Rachel Strength","orcid":"0000-0002-6306-1228","position":0,"is_corresponding":true}],"reference_count":10,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:52:00.885532Z","pmid":"40209103","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}