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These follow-up studies often found one third with a good outcome, one third with a moderate outcome and one third with a poor outcome [ 2, 3].
For instance, a recent study on hypoxic ischemic encephalopathy in preterm babies describes that one-third of the infants had normal outcomes, one-third died, and one-third showed impairments ranging from mild motor delays to severe cerebral palsy.
In the Scottish incidence study, the same distribution was found; roughly one-third had a good outcome, one-third were mildly to moderately disabled and one-third were severely disabled [ 2].
At study end, although the RCT itself was sufficiently powered for its primary outcome, only one third (35%) of GPs had met the recruitment target and 27% had failed to enroll a single patient.
Pravastatin 10 20 mg daily reduced the risk of coronary heart disease (primary outcome) by one third (HR 0.67, 95% CI 0.49 to 0.9) compared to control but did not have a significant effect on any first-ever stroke (2.5% vs 3.0%, HR 0.83, 95% CI: 0.57 to 1.21).
Of the 34 relapsed DP 6 patients included in the outcome analysis, one third typed for DPB1*0601, but there was no discernable difference in their clinical characteristics compared with non-relapsed DP 6 patients (age, sex, presenting white cell count, immunophenotype, karyotype of cells at diagnosis), indicating that DP 6 does not have independent prognostic value in UKALL XI.
Half of the studies reported worse mortality outcomes for migrants, one third did not find considerable differences and a few found better mortality outcomes for migrants compared with the non-migrant population [ 12].
Considerable heterogeneity existed (I=66%) when we compared placebo acupuncture with no acupuncture but not when we compared acupuncture with placebo acupuncture (I=36%), although both analyses were based on the same trials and the same outcomes and approximately one third of the patients were identical (those in the placebo groups).
More than forty percent of private practice responders indicated using one or two outcome measures and one third indicated using three to five outcome measures in clinical practice.
In a pilot trial, Bleidorn et al. reported on the non-inferiority of ibuprofen versus ciprofloxacin based on symptomatic outcome on Day 4, however, one third of patients of the ibuprofen group relapsed within the first week [6].
Our study shows that about one in five published randomised clinical trials use surrogate outcomes and that only one third of these report that they have used a surrogate and discuss its validity.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com