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.
Please do not ask me what dose you should be on. I genuinely do not know and neither does anyone else here.
best — the order this archive was captured in
Open-label extensions lose their randomisation. Anybody still enrolled at week 104 is a selected group and the numbers describe that group.
Careful with that mean. The distribution around it was wide enough that it describes very few individual participants.
Started keeping the trial identifiers straight in a note file because I kept mixing up two programmes in the same sentence.
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.
Right — trial participants get structured support. Comparing yourself to a trial mean is comparing across two different interventions.
Yes — the interval is the finding. A point estimate with a wide interval is a hypothesis in a nice font.
FLOW was kidney outcomes and it is the one nobody quotes
Yes. The appendix tables are where the subgroup and the adverse event detail actually live.
SELECT was cardiovascular outcomes, not weight
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.
Press-release posts get their own flair here. Nothing wrong with them, they are just a different kind of claim.
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.
Correction: SURMOUNT is the obesity programme and SURPASS is the diabetes one. The figure you quoted belongs to the other one.
Small fix — that was the cardiovascular outcomes trial, so weight was a secondary endpoint and the population was different.
Quoted a figure here confidently, got asked whether it was ITT, went and checked, and it was not. Learned something.
Agreed on comparators. "Superior" means nothing until you know superior to what and at what dose.
Argued for a week about a result and then read the limitations section, which conceded most of my opponent’s point.
Argued for a week about a result and then read the limitations section, which conceded most of my opponent’s point.
joaquin_trevino is right about the programme names. They are different populations with different endpoints.
Read a press release and the publication three months apart. The hedging in the second one was substantial.
check who the comparator was before you compare anything
Went looking for the registered protocol to see whether the endpoint had changed. It had not, which was reassuring and worth checking.
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.
a mean is not a promise
a mean is not a promise
This is the distinction that would end about half the arguments on this board.
- 1Quoted a figure here confidently, got asked whether it was ITT, went and…6 comments in this branch · started by u/week_one_wanda