Per-Protocol or ITT? Choosing the Wrong Population Analyses Inflates Efficacy

VIVIO Advisor, Bishal Gyawali, MD PhD, explains how mis-applied population analyses can warp clinical trial conclusions.

Medscape, 10/14/2025

Dr. Bishal Gyawali explains why choosing the wrong analytic population in clinical trials can create misleading results. Using examples from recent studies, including the TransMet and NordICC trials, he illustrates how per-protocol and as-treated analyses can artificially inflate treatment benefits — and why intention-to-treat analyses remain the gold standard for accurately assessing real-world efficacy.