Value of Central Event Adjudication

To the Editor:The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) Collaborative Group notes that the End Point Adjudication Committee (EPAC) process had no discernible impact on that trial’s statistical conclusions.1 However, we caution that this result is not necessarily representative and that an EPAC is a wise investment for most studies. This claim is supported by the following points.First, the rejection rate of 9.9% seen in PROGRESS is low by our experience. Traditionally, one asks investigators to “cast a wide net” and send in any possible event, even if they believe it unlikely to be a true event, to ensure that no true events escape detection (ie, no false-negatives). This process leads to more spurious events, but that …