The Continuous Fragility Quotient as a Model-Free Assessment for Continuous Outcomes
DOI:
https://doi.org/10.5281/zenodo.19445024Keywords:
continuous fragility quotient, CFQ, statistical fragility, continuous fragility index, continuous outcomes, fragility index, global fragility index, neutrality boundary frameworkAbstract
The continuous fragility quotient (CFQ) is a model-free fragility metric for continuous outcomes that derives entirely from the Welch t-statistic geometry, requiring only published summary statistics. Unlike the continuous fragility index (CFI), which reconstructs pseudo-observations under distributional assumptions, CFQ produces a unique, analyst-independent value normalized to [0,1] for cross-study comparison. CFQ pairs with the Meaningful Change Index (MeCI) to complete the p–fr–nb triplet for continuous outcome trials.
References
Caldwell J-ME, Youssefzadeh K, Limpisvasti O. A method for calculating the fragility index of continuous outcomes. J Clin Epidemiol. 2021;136: 20-25. doi:10.1016/j.jclinepi.2021.02.023
Heston TF. Fragility Metrics Toolkit. Zenodo; 2026. doi:10.5281/zenodo.17254763
Walsh M, Srinathan SK, McAuley DF, Mrkobrada M, Levine O, Ribic C, et al. The statistical significance of randomized controlled trial results is frequently fragile: a case for a Fragility Index. J Clin Epidemiol. 2014;67: 622–628. doi:10.1016/j.jclinepi.2013.10.019
Heston TF. The Global Fragility Index: A Path-Independent Measure of Statistical Fragility. Zenodo. 2025. doi:10.5281/zenodo.18078509
Chan J, Vrla M, Thompson C, Trofa D, Li X, Wang D, et al. Fragility of Assumptions: Response. Orthop J Sports Med. 2026;14: 23259671251409149. doi:10.1177/23259671251409149
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Copyright (c) 2026 Thomas F. Heston, MD, MSc

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