Which statement best describes how endpoint adjudication committees operate to minimize bias?

• A. Endpoints are reviewed in blinded fashion to minimize bias.
• B. Endpoints are reviewed with full knowledge of treatment assignment.
• C. Endpoints are not reviewed by independent committees.
• D. Endpoints are randomly chosen.

Answer: (A)

The key idea is that endpoint adjudication committees aim to judge outcomes without letting knowledge of treatment influence the decision. By having trained clinicians review potential endpoints using predefined criteria, and doing so in a blinded fashion so they don’t know which treatment arm a participant was in, judgments become more objective and consistent. This independent, centralized review reduces biases that might come from expectations about a drug’s effect or from investigators’ classifications at sites.

If adjudicators knew which treatment arm a participant received, their judgments could be swayed by expectations, leading to biased endpoint classification. Not using independent committees would reintroduce subjective variation and potential bias from site investigators. Randomly choosing endpoints wouldn’t address how events are classified once they occur, so it wouldn’t minimize bias in endpoint determination.