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c/trialwatch·posted 6 months ago by u/nordic_pricing

someone explain FLOW to me like I have not read a paper in years

Discussion Clean Column ×2 Slow Clap ×1

someone explain FLOW to me like I have not read a paper in years. Searched first, found three threads that contradict each other, hence the post.

The discontinuation numbers were the most useful thing in the paper for me and they were in a supplementary table.

Compared myself to a trial mean for about six months before realising the trial arm had dietitian contact every fortnight.

Started keeping the trial identifiers straight in a note file because I kept mixing up two programmes in the same sentence.

If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.

2,074 up / 102 down95% upvoted51 commentsid 3biau420 Jan 2026

51 comments

30 in this archive, depth 5

best — the order this archive was captured in

u/cesar_ivaturi360 points·6 months ago

Cardiovascular outcome trials are powered for events, not for weight, and are typically run in a different population with different inclusion criteria. Reading a weight number out of one is reading a secondary endpoint.

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u/hazard_ratio_halMOD213 points·6 months ago

Added the trial identifier to the title so this thread is findable in two years.

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u/iman_castellanos400 points·6 months ago

trial populations get support that nobody on this board gets

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u/nhs_waitlist_nUK142 points·6 months ago

trial populations get support that nobody on this board gets

Disagreeing with this line: that is a relative reduction and the absolute numbers are considerably less dramatic.

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u/receipts_or_nothingvetting77 points·6 months ago

Small fix — that was the cardiovascular outcomes trial, so weight was a secondary endpoint and the population was different.

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u/ewan_tulloch72 points·6 months ago

STEP is semaglutide obesity, SURMOUNT is tirzepatide obesity, they are not interchangeable

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u/zaid_roos59 points·6 months ago·edited

Correction: SURMOUNT is the obesity programme and SURPASS is the diabetes one. The figure you quoted belongs to the other one.

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u/nhs_waitlist_nUK240 points·6 months ago·edited

That is a relative risk reduction. Quoting it without the absolute numbers overstates the case considerably.

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[removed]104 points·6 months ago

[removed by moderator]

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u/milan_mensah65 points·6 months ago

Disagree — that figure is from the diabetes programme and you are quoting it as an obesity endpoint.

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u/zaid_roos151 points·6 months ago

What was the comparator?

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u/arne_ilunga-6 points·6 months ago

the appendix is where the interesting tables live

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u/marit_laurent139 points·6 months ago

Not convinced. Cross-trial comparison between two programmes with different populations and designs is not a comparison.

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u/yusuf_ramos93 points·6 months ago

That is the 68-week readout, not the 72-week one. Different trial, different duration.

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u/nordic_pricingOP68 points·6 months ago

That is the 68-week readout, not the 72-week one.

yusuf_ramos is right about the programme names. They are different populations with different endpoints.

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u/anders_karlsen41 points·6 months ago

What did the confidence interval look like?

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u/naomi_ekstrom22 points·6 months ago

SELECT was cardiovascular outcomes, not weight

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u/nordic_pricingOP25 points·6 months ago

Is that intention-to-treat or completers?

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u/nora_oyelaran20 points·6 months ago

The press release said that; the publication says something more hedged. Worth reading both.

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u/hugo_norgaard86 points·6 months ago

What was the discontinuation rate?

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u/tove_ogunleye64 points·6 months ago

Push back: an open-label extension tells you about the people who stayed. That is a different question.

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u/kaia_cabrera48 points·6 months ago

Same. A press release is a claim about a result; the publication is the result.

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u/tb500_tangent39 points·6 months ago

Relative risk reduction without the baseline rate is uninterpretable. A large relative reduction on a small absolute risk is a small absolute benefit.

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u/pancreatitis_scare25 points·6 months ago

Careful with that mean. The distribution around it was wide enough that it describes very few individual participants.

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u/oskar_ibarra31 points·6 months ago

Do you have the publication or the press release?

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u/piotr_bruun10 points·6 months ago

read the endpoint before you read the headline

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u/laila_almeida6 points·6 months ago·edited

read the endpoint before you read the headline

This is the distinction that would end about half the arguments on this board.

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u/rania_salinas9 points·6 months ago

The registered protocol is public. Comparing the registered primary endpoint with the reported one is a two-minute check and it is how outcome switching gets caught.

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u/bastian_ekstrom28 points·6 months ago

the confidence interval is the finding, the point estimate is the headline

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u/ines_boateng23 points·6 months ago

SURPASS is the diabetes programme and reports glycaemic endpoints

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Clinical trial reading group. New readouts, protocol amendments, endpoint definitions, dropout handling, and the difference between a press release and a publication. Absolute risk reduction and number-needed-to-treat are house dialect here.

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