Epidemiology: surrogate end point: practice question

A PSM question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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PSM · Epidemiology: surrogate end point

Sample item

A trial of a new antihypertensive drug uses reduction in systolic blood pressure as its main outcome, instead of the occurrence of stroke or death. This outcome is called a:

AConfounderBHard clinical end pointCSurrogate end pointDPrimary prevention indicator

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Surrogate end point

A surrogate end point is a laboratory or physical measure used instead of a clinical outcome that matters to patients, in the expectation that it predicts that outcome. Stroke and death are hard clinical end points. Surrogates allow shorter, smaller trials but may not reflect true benefit.

Option by option

A. Confounder
A confounder is a third factor linked to exposure and outcome and is not an outcome measure.
B. Hard clinical end point
A hard end point would be the clinical event such as stroke or death.
C. Surrogate end point (correct)
Correct. Blood pressure stands in for stroke and death, so it is a surrogate.
D. Primary prevention indicator
This is not a standard term for a trial outcome.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this PSM question

What is the answer to this PSM question?

The best answer is C, Surrogate end point. A surrogate end point is a laboratory or physical measure used instead of a clinical outcome that matters to patients, in the expectation that it predicts that outcome.

Why is "Confounder" not the answer?

A confounder is a third factor linked to exposure and outcome and is not an outcome measure.

Why is "Hard clinical end point" not the answer?

A hard end point would be the clinical event such as stroke or death.

Why is "Primary prevention indicator" not the answer?

This is not a standard term for a trial outcome.

What concept does this question test?

It tests Epidemiology: surrogate end point in PSM. Stroke and death are hard clinical end points. Surrogates allow shorter, smaller trials but may not reflect true benefit.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Epidemiology: surrogate end point?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.