What does it mean when a trial shows treatment B is “not noninferior” to treatment A? Why the convoluted wording?

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I always have trouble making sense of noninferiority studies. If treatment B is noninferior to A, I can understand that. But when it says B is NOT noninferior to A, why can’t they just say B is inferior to A? What’s the difference?

Example of such a trial: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)00537-2/fulltext

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Anonymous 0 Comments

With any trial of a drug or placebo there is a likely effect estimate and a confidence about that estimate. If another drug or placebo is tested and the effect size falls clearly above a margin for the first estimate, then all you can say is that it was not worse. Since you are not comparing them to see which is better. There are superiority margins sometimes that people define. But often the way a study is conducted makes this kind of assertion problematic.

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