Figure 3. Schematic of the global rank score.

In this example, patients are randomized to receive either a control or experimental therapy. Using the global rank score, a composite outcome of 30-day mortality, HF hospitalization, heart failure symptoms, and BNP level is employed. Patients are sorted into 4 groups using a hierarchical approach: A) experienced mortality within 30 days, B) alive but hospitalized for HF, C) no hospitalizations but experienced worsened HF symptoms, and D) patients without hospitalizations or worsening HF symptoms. Patients in the first two groups (A–B) are ranked by time to event. The latter two groups (C–D) are ranked by HF severity score and BNP level. A global rank score is obtained for each treatment group by adding the respective patients ranks. A higher score indicates improved outcomes.