The top of baseline_score is 1.1× the 99th percentile

baseline_score on clinical-trial: p99 is 85.60 and the max is 96.00.

The max is 1.1× the 99th percentile and 3.2 standard deviations above the mean. The median is 61.30, so the top of this column lives in a different regime from the middle of it.

select *
from clinical_trial
order by baseline_score desc
limit 20;

Run that before deciding anything. There are three things an extreme value can be, and they need opposite treatment: a data error, a real but rare event, or a different population that got mixed into the same table. Only the first is safe to drop, and you cannot tell them apart from the summary statistics — you have to look at the rows.

A ratio this modest is consistent with an ordinary heavy tail — nothing anomalous, just a distribution that is not symmetric.

Clipping at the 99th percentile is a decision to discard your most interesting rows. Sometimes right. Never automatic, and never silent — if a number in a report was computed on clipped data, the report has to say so.