the STEP question that gets asked weekly, answered properly
Something I keep coming back to: the STEP question that gets asked weekly, answered properly.
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.
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.
Relative risk reduction without the baseline rate is uninterpretable. A large relative reduction on a small absolute risk is a small absolute benefit.
Corrections welcome, especially the pedantic ones. Pedantry is how this board earns its reputation.
best — the order this archive was captured in
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.
Press-release posts get their own flair here. Nothing wrong with them, they are just a different kind of claim.
a mean is not a promise
a mean is not a promise
Agreed. And the interval, not the point estimate, is what the trial actually established.
Disagree — that figure is from the diabetes programme and you are quoting it as an obesity endpoint.
On means, which this board treats as targets and which are nothing of the sort.
A reported mean body weight change is the centre of a distribution that in these trials is very wide. Substantial numbers of participants did much better, and substantial numbers did considerably worse while remaining on the drug and in the analysis.
Quoting the mean as an expectation therefore misleads in both directions: it makes ordinary results look like failures and it makes exceptional results look normal. If a paper publishes the distribution — and several do, in the appendix — look at that instead. It is far more informative than the number in the abstract.
What did the confidence interval look like?
SURPASS is the diabetes programme and reports glycaemic endpoints
How long was the randomised phase before any extension?
check who the comparator was before you compare anything
Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.
discontinuation rate is a result, not a footnote
What was the discontinuation rate?
registry entry, protocol, publication — three different documents
- 1SURPASS is the diabetes programme and reports glycaemic endpoints7 comments in this branch · started by u/annika_fonseca