Variables ranked according to clinical importance

It may be possible with several primary endpoints to rank these in terms of their clinical importance and with this structure adopt a testing strategy which 

2 is non-significant then we are not allowed to look at endpoint 3. In case 

3 no claims can be made. The CPMP (2002) Points to Consider on Multiplicity Issues in Clinical Trials specifically mentions some examples of this strategy  

Clearly it is very important that we get the hierarchy correct. Generally this would be determined by the clinical relevance of the endpoints, although under some circumstances it could be determined, in part, by the likelihood of seeing statistical significance with the easier hits towards the top of the hierarchy. 

These ideas can also be considered as a way of dealing with secondary endpoints which might be considered for inclusion in a claim. In many cases secondary endpoints are simply primary endpoints lower down in the hierarchy. 

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