[PSA] STEP is not what most of this community thinks it is
STEP is not what most of this community thinks it is — with the reasoning, because a rule without a reason gets ignored. Started keeping the trial identifiers straight in a note file because I kept mixing up two programmes in the same sentence. Quoted a figure here confidently, got asked whether it was ITT, went and…
How to read one of these papers in fifteen minutes, in the order that actually helps.
Start with the registered protocol and check the primary endpoint against what is reported. Then the methods: who was included, what the comparator was, how long the randomised phase ran. Then the discontinuation numbers, which are a tolerability result and are usually in a supplementary table.
Only then the efficacy figure, and read the interval rather than the point estimate. Finish with the limitations section, which is where the authors say what they actually think.
Fifteen minutes, and you will know more than any thread summarising it.
A confidence interval is the range of effects compatible with the data. Two trials with overlapping intervals have not disagreed, whatever their point estimates look like next to each other.
Absolute or relative risk reduction?
the appendix is where the interesting tables live
discontinuation rate is a result, not a footnote
Went looking for the registered protocol to see whether the endpoint had changed. It had not, which was reassuring and worth checking.
SURPASS is the diabetes programme and reports glycaemic endpoints
Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.
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registry entry, protocol, publication — three different documents