Background:The focus of the present Letter is on the large and seemingly fertile body of work
captured under the umbrella of ‘patient stratification’.Objectives:I identify and explain a fundamental methodological flaw underlying the manner in which
the development of an increasingly large number of new stratification strategies is
approached.Design:I show an inherent conflict between the assumptions made, and the very purpose of
stratification and its application in practice.Methods:I analyse the methodological underpinnings of stratification as presently done and draw
parallels with conceptually similarly flawed precedents which are now widely
recognized.Results:The highlighted flaw is shown to undermine the overarching ultimate goal of improved
patient outcomes by undue fixation on an ill-founded proxy.Conclusion:I issue a call for a re-think of the problem and the processes leading to the adoption
of new stratification strategies in the clinic.