Basically I erred in putting too much faith in the DSMC, which pretty much the same as everybody else on this forum. The DSMC made the recommendation to proceed with no changes and everybody thought it was a lock to meet endpoints. Should we delete all those posts too because obviously it seemed like they completely failed in their role? Even though they may not have the insights into age & critical patients imbalance, wouldn't they have done a quick PE & SE mortality calc (unadjusted) and seen that there was a potential issue with meeting stat significance?
However, it's still hard for me think the DSMC failed so miserably. This leads me to think that a 50% review just doesn't cut it. The big lesson learned here is that a 75% review may be more beneficial than we think. Take the MESO Covid trial for instance. At 50%, MESO was told to proceed unchanged. It was not until the 75% review that it was stopped for futility. That's a major difference!