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" ... But that should not deter us from a debate. We live in a dichotomania world obsessed by up-or-down results from null-hypothesis significance testing and p-values. It is clear that the ISCHEMIA investigators were thoughtful and did not make their decision to change its primary endpoint lightly. But this is what makes Rajkumar et al.’s observations so important, regardless of whether this change was pre- or post-specified. I’m glad the ISCHEMIA investigators will be providing us with additional insights and also that we are having this debate now - even before its results are known. ... "