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Outcome switching
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==Pre-specified outcomes == When a clinical trial has a protocol published in advance, it will typically include [[pre-specified outcome|pre-specified primary outcomes]], these are the main measures used to determine if an intervention or drug is effective. Secondary outcomes are considered to be less important. For example, change in average pain level measured with a questionnaire, biological test results or physical measurements of ability.{{citation needed}} Outcome swapping is the process of changing these primary outcomes during the trial or prior to publication.{{citation needed}} For example, a secondary outcome may be changed with a primary outcome, which may give then change the results reported in the trial publication. In the [[PACE trial]], outcome swapping led to results showing that both [[CBT]] and [[GET]] were moderately effective, but when a secondary analysis used the original pre-specified outcomes this showed the interventions were less effective than the previously published results.{{citation needed}}
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