Abstract: FR-PO0041
Innovative Visualization of Treatment Effects in Kidney Disease Trials Using Hierarchical Composite End Points
Session Information
- Artificial Intelligence and Digital Health at the Bedside
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Artificial Intelligence, Digital Health, and Data Science
- 300 Artificial Intelligence, Digital Health, and Data Science
Authors
- Karpefors, Martin, AstraZeneca, Gothenburg, Sweden
- Little, Dustin J., AstraZeneca, Boston, Massachusetts, United States
- Heerspink, Hiddo Jan L., University Medical Center Groningen, Groningen, Netherlands
- Gasparyan, Samvel B., AstraZeneca, Boston, Massachusetts, United States
Background
Hierarchical Composite Endpoints (HCEs) have emerged as a novel tool for evaluating treatment effects in clinical trials for kidney disease by combining multiple time-to-event outcomes and a continuous endpoint. A particular case is the kidney disease progression HCE, which captures effect on critical outcomes such as death, kidney failure, and sustained declines in estimated glomerular filtration rate (eGFR).
Methods
We introduce several state-of-the-art visualizations tailored to HCEs, including maraca plots, Dustin plots, 2-dimensional mosaic plots, and sunset plots. Maraca plots offer a granular view of individual components of the HCE, providing a comprehensive overview of all the outcomes in one visualization. Dustin plots show how the treatment effect changes as the individual components are cumulatively added. Mosaic plots are designed to directly demonstrate win probabilities and win odds visually. Finally, Sunset plots are useful during trial design, offering a “topological” view of the combinations of hazard ratio and mean difference in continuous distributions that result in the same win odds.
Results
The visualization of these endpoints is essential not only to understand the statistical results, like win ratio and win odds, but also to communicate them effectively in clinical settings. These visualization techniques enhance the transparency and interpretability of trial findings, thereby aiding in the communication of the treatment's impact on slowing kidney disease progression. By employing these methods, researchers and clinicians can better understand and convey the overall benefits or risks associated with an intervention, thereby advancing the field of nephrology research.
Conclusion
This work underscores the importance of visual tools in clinical trial reporting, paving the way for more informed decision-making in the management of kidney disease.
Dustin plot.
Funding
- Commercial Support – AstraZeneca R&D