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c/trialwatch·posted 8 months ago by u/rt_shift_reggie

SURPASS — 6 things I got wrong before I got it right

Readout Long Haul ×2 Clean Column ×3

SURPASS — 6 things I got wrong before I got it right. It is the sort of thing everyone half-believes and nobody writes down.

Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.

Quoted a figure here confidently, got asked whether it was ITT, went and checked, and it was not. Learned something.

Read a press release and the publication three months apart. The hedging in the second one was substantial.

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

2,134 up / 334 down86% upvoted26 commentsid 4os17e12 Nov 2025

26 comments

23 in this archive, depth 4

best — the order this archive was captured in

u/britta_boateng199 points·8 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/adaeze_cabrera161 points·8 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/pancreatitis_scare96 points·8 months ago

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

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u/trialwatch_theoMOD125 points·8 months ago

Left up and flaired Trial Data. The publication is linked rather than the coverage, which is what we ask for.

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u/valeria_karlsen56 points·8 months ago

Agreed. Half the arguments on this site are two people quoting different trials at each other without noticing.

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u/camila_vasquez61 points·8 months ago

Argued for a week about a result and then read the limitations section, which conceded most of my opponent’s point.

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u/arne_ilunga83 points·8 months ago

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

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u/nils_tulloch-11 points·8 months ago

registry entry, protocol, publication — three different documents

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u/adaeze_cabrera1 point·8 months ago

Correcting myself upthread: I gave the completer figure and labelled it intention-to-treat.

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u/rt_shift_reggieOP1 point·8 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/nightowl_injector1 point·8 months ago

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.

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u/rina_bergstrom1 point·8 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/rt_shift_reggieOP1 point·8 months ago

How long was the randomised phase before any extension?

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u/rt_shift_reggie55 points·8 months ago

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

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u/tomas_kimani24 points·8 months ago

Yes. The appendix tables are where the subgroup and the adverse event detail actually live.

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u/customs_seizure_sid7 points·8 months ago

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

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u/aurel_mwangi31 points·8 months ago

Is that intention-to-treat or completers?

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u/rt_shift_reggieOP20 points·8 months ago

a press release is not a publication

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u/adaeze_weiss23 points·8 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/yannick_salinas19 points·8 months ago

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

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u/nhs_waitlist_nUK12 points·8 months ago

What was the comparator?

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u/heart_rate_bump8 points·8 months ago

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.

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u/trialwatch_theotrial nerd4 points·8 months ago·edited

Do you have the publication or the press release?

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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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