[Discussion] TRIUMPH is doing more work than we give it credit for
TRIUMPH is doing more work than we give it credit for. Making the case below, and I expect to lose some of it in the comments.
Argued for a week about a result and then read the limitations section, which conceded most of my opponent’s point.
The discontinuation numbers were the most useful thing in the paper for me and they were in a supplementary table.
Went looking for the registered protocol to see whether the endpoint had changed. It had not, which was reassuring and worth checking.
Screenshot none of this. Read the whole thread, including the parts where I am told I am wrong.
best — the order this archive was captured in
Cosigning on discontinuation. It is a result about tolerability and it gets buried every time.
That is the 68-week readout, not the 72-week one. Different trial, different duration.
The press release said that; the publication says something more hedged. Worth reading both.
SELECT was cardiovascular outcomes, not weight
Correcting myself upthread: I gave the completer figure and labelled it intention-to-treat.
Agreed. Half the arguments on this site are two people quoting different trials at each other without noticing.
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.
Correction: SURMOUNT is the obesity programme and SURPASS is the diabetes one. The figure you quoted belongs to the other one.
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.
Small fix — that was the cardiovascular outcomes trial, so weight was a secondary endpoint and the population was different.
registry entry, protocol, publication — three different documents
the confidence interval is the finding, the point estimate is the headline
discontinuation rate is a result, not a footnote
intention to treat versus completers changes the number substantially
FLOW was kidney outcomes and it is the one nobody quotes
Disagree — that figure is from the diabetes programme and you are quoting it as an obesity endpoint.
phase 2 finds a dose, phase 3 measures the effect
phase 2 finds a dose, phase 3 measures the effect
Disagreeing with this line: that is a relative reduction and the absolute numbers are considerably less dramatic.
Right — trial participants get structured support. Comparing yourself to a trial mean is comparing across two different interventions.
STEP is semaglutide obesity, SURMOUNT is tirzepatide obesity, they are not interchangeable
SURPASS is the diabetes programme and reports glycaemic endpoints
- 1Cosigning on discontinuation. It is a result about tolerability and it gets…7 comments in this branch · started by u/draw_up_dizzy
- 2A confidence interval is the range of effects compatible with the data. Two…7 comments in this branch · started by u/week_four_wall