Advances and applications of the Win Ratio in clinical studies

The Win Ratio (WR) method, introduced by Pocock et al. in 2011, offers a novel statistical approach to enhance the analysis of composite outcomes with varying severities by accounting for the relative priority of each component. The WR accommodates mixed outcome types (e.g., time-to-event, categorical, and continuous) without relying on distributional assumptions by comparing pairs of patients and assigning a "win" to the patient with the better outcome for each pair. This method accounts patient and/or provider priorities when prioritizing endpoints, leading to more clinically relevant results. In this session, we present several advances of the WR that tackle missing data, interim analyses, confounding, and improved power through weighting. We further illustrate the application of the WR in both clinical trial and observational study settings. This session will have broad appeal to both methodologists and practitioners in the biomedical field.