[PSA] STEP is not what most of this community thinks it is
STEP is not what most of this community thinks it is — with the reasoning, because a rule without a reason gets ignored.
Started keeping the trial identifiers straight in a note file because I kept mixing up two programmes in the same sentence.
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.
I will update this if the picture changes rather than quietly leaving it up.
best — the order this archive was captured in
How to read one of these papers in fifteen minutes, in the order that actually helps.
Start with the registered protocol and check the primary endpoint against what is reported. Then the methods: who was included, what the comparator was, how long the randomised phase ran. Then the discontinuation numbers, which are a tolerability result and are usually in a supplementary table.
Only then the efficacy figure, and read the interval rather than the point estimate. Finish with the limitations section, which is where the authors say what they actually think.
Fifteen minutes, and you will know more than any thread summarising it.
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.
Absolute or relative risk reduction?
the appendix is where the interesting tables live
discontinuation rate is a result, not a footnote
Went looking for the registered protocol to see whether the endpoint had changed. It had not, which was reassuring and worth checking.
SURPASS is the diabetes programme and reports glycaemic endpoints
Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.
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registry entry, protocol, publication — three different documents
Careful with that mean. The distribution around it was wide enough that it describes very few individual participants.
Do you have the publication or the press release?
Small fix — that was the cardiovascular outcomes trial, so weight was a secondary endpoint and the population was different.
Agreed on comparators. "Superior" means nothing until you know superior to what and at what dose.
Not convinced. Cross-trial comparison between two programmes with different populations and designs is not a comparison.
Retitled: the original quoted a diabetes endpoint as an obesity result.
SELECT was cardiovascular outcomes, not weight
Push back: an open-label extension tells you about the people who stayed. That is a different question.
Push back: an open-label extension tells you about the people who stayed.
This is the distinction that would end about half the arguments on this board.
Compared myself to a trial mean for about six months before realising the trial arm had dietitian contact every fortnight.
Push back: an open-label extension tells you about the people who stayed.
iman_castellanos is right about the programme names. They are different populations with different endpoints.
- 1How to read one of these papers in fifteen minutes, in the order that…10 comments in this branch · started by u/hsa_math
- 2Retitled: the original quoted a diabetes endpoint as an obesity result.6 comments in this branch · started by u/trialwatch_theo