the STEP question that gets asked weekly, answered properly
the STEP question that gets asked weekly, answered properly. Not a hot take, just something I have not seen said plainly here.
Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.
Relative risk reduction without the baseline rate is uninterpretable. A large relative reduction on a small absolute risk is a small absolute benefit.
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.
If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.
best — the order this archive was captured in
Compared myself to a trial mean for about six months before realising the trial arm had dietitian contact every fortnight.
Intention-to-treat analyses everybody randomised regardless of what they did afterwards. Completer analyses only those who finished. The second is systematically more flattering and both are legitimate if labelled.
Open-label extensions lose their randomisation. Anybody still enrolled at week 104 is a selected group and the numbers describe that group.
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SELECT was cardiovascular outcomes, not weight
That is the 68-week readout, not the 72-week one. Different trial, different duration.
That is the 68-week readout, not the 72-week one.
This is the distinction that would end about half the arguments on this board.
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.
Cardiovascular outcome trials are powered for events, not for weight, and are typically run in a different population with different inclusion criteri
Adding the check nobody runs — the registered protocol is public and takes two minutes to compare.
This. Intention-to-treat versus completer analysis routinely moves the headline by several points.
Yes — the interval is the finding. A point estimate with a wide interval is a hypothesis in a nice font.
What did the confidence interval look like?
Read a press release and the publication three months apart. The hedging in the second one was substantial.
Not convinced. Cross-trial comparison between two programmes with different populations and designs is not a comparison.
Quoted a figure here confidently, got asked whether it was ITT, went and checked, and it was not. Learned something.
intention to treat versus completers changes the number substantially
Right — trial participants get structured support. Comparing yourself to a trial mean is comparing across two different interventions.
Started keeping the trial identifiers straight in a note file because I kept mixing up two programmes in the same sentence.
trial populations get support that nobody on this board gets
Discontinuation rates are a tolerability result. A trial with a strong efficacy number and heavy discontinuation is telling you two things and people only quote one.
SURPASS is the diabetes programme and reports glycaemic endpoints
FLOW was kidney outcomes and it is the one nobody quotes
Agreed on comparators. "Superior" means nothing until you know superior to what and at what dose.
Agreed. Half the arguments on this site are two people quoting different trials at each other without noticing.
That is a relative risk reduction. Quoting it without the absolute numbers overstates the case considerably.
Cosigning on discontinuation. It is a result about tolerability and it gets buried every time.
Careful with that mean. The distribution around it was wide enough that it describes very few individual participants.
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.
- 1Cardiovascular outcome trials are powered for events, not for weight, and…11 comments in this branch · started by u/ahmed_iyer
- 2Discontinuation rates are a tolerability result. A trial with a strong…6 comments in this branch · started by u/ines_boateng