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Non-Inferiority and Equivalence

Switching Between Superiority and Non-Inferiority Designs Calculator

Assess how a treatment-effect confidence interval relates to both a superiority boundary of 0 and a prespecified non-inferiority margin. The calculator shows whether the result supports superiority, non-inferiority only, inferiority, or an indeterminate result.

Trial Result

Enter the estimated treatment effect and its standard error. Positive values mean the new treatment is better than control.
Use the same effect scale for the estimate, standard error, and margin. For example, enter 0.45, 0.296, and 2.00 when effects are expressed as percentage points.

Switching Assessment

The same confidence interval is evaluated against zero and the prespecified non-inferiority boundary −Δ.
Enter the trial result and click Assess Switching.

Methodology

This calculator evaluates a treatment effect defined as new treatment minus control, with positive values favoring the new treatment. It uses the normal-approximation confidence interval estimate ± z1−α/2 × SE.

Superiority

For a two-sided confidence level of 1−α, statistical superiority in the prespecified favorable direction is supported when the entire confidence interval is above zero. Equivalently, the lower confidence limit is greater than 0.

Non-inferiority

With a non-inferiority margin Δ > 0, the null boundary is −Δ on the treatment-effect scale. Non-inferiority is supported when the lower confidence limit is above −Δ. A confidence interval that crosses −Δ does not establish non-inferiority.

CI = d ± z1−α/2 SE
Superiority: lower CI > 0
Non-inferiority: lower CI > −Δ
Inferiority: upper CI < −Δ
Otherwise: indeterminate with respect to the NI margin

Interpreting a switch

If a non-inferiority trial produces a confidence interval entirely above zero, the result also supports statistical superiority. Conversely, a superiority trial that does not establish superiority can support non-inferiority only when an acceptable non-inferiority margin was defined prospectively and the trial satisfies the relevant design and conduct requirements. A post hoc choice of a margin should not be used to manufacture a non-inferiority conclusion.

The regulatory guidance emphasizes that switching the objective is more than a mechanical comparison of p-values. The comparator, endpoint, population, trial conduct, analysis populations, sensitivity, and justification of the non-inferiority margin all matter. This calculator therefore reports the statistical CI relationship but does not by itself certify that a regulatory switch is appropriate.

References

Committee for Proprietary Medicinal Products (CPMP). (2001). Points to consider on switching between superiority and non-inferiority. British Journal of Clinical Pharmacology, 52, 223–228. DOI: 10.1046/j.1365-2125.2001.01397-3.x.

Lewis, J. A. (2001). Switching between superiority and non-inferiority: an introductory note. British Journal of Clinical Pharmacology, 52(3), 221. DOI: 10.1046/j.0306-5251.2001.01424.x-i1.

Althunian, T. A., de Boer, A., Klungel, O. H., & Stolk, P. (2017). Defining the noninferiority margin and analysing noninferiority: An overview. British Journal of Clinical Pharmacology, 83, 1636–1642. DOI: 10.1111/bcp.13280.

this method is a commercial power and sample-size package from the software. the relevant methodological literature describes separate non-inferiority and superiority-by-a-margin procedures and notes that its procedures can solve for power, sample size, and effect size depending on the procedure.