LAUSR

E ach week, a practicing physician may read the latest medical journal and find a new intervention claiming to be non-inferior to a therapy she uses, while offering the advantage of freedom from monitoring, lower cost, or less toxicity. In an ideal world, such trials could be accepted at face value, but a growing body of evidence suggests that when it comes to non-inferiority trials: reader beware. The ubiquity of non-inferiority trials raises important questions: how often do they find non-inferiority? Are industrysponsored trials more likely to reach favorable conclusions? Is the definition of non-inferiority chosen for good clinical reasons? Are there interventions that are actually inferior, but are somehow deemed Bnon-inferior^? Many of these questions are answered by the tour-de-force article by Aberegg, Hersh, and Samore, which examines 183 non-inferiority comparisons from 163 clinical trials appearing in the five highest impact factor medical journals.