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c/trialwatch·posted 2 years ago by u/rohan_steiner

why does nobody talk about SELECT

Trial Data Well Actually ×8 Long Haul ×3

Asking properly rather than in a comment on somebody else’s thread: why does nobody talk about SELECT.

Relative risk reduction without the baseline rate is uninterpretable. A large relative reduction on a small absolute risk is a small absolute benefit.

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

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.

Would rather be corrected in public than confident in private.

2,627 up / 61 down98% upvoted40 commentsid 15azwo14 Nov 2023

40 comments

3 in this archive, depth 2

best — the order this archive was captured in

u/rohan_cardoso0 points·2 years 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/hsa_math113 points·2 years ago

Why comparing across trials almost never works, with the specific failure modes.

Different populations: an obesity programme and a diabetes programme enrol different people with different baseline characteristics. Different endpoints: body weight change, glycaemic control and cardiovascular events are not convertible. Different durations: 68 weeks and 72 weeks are not the same, and the curves have not flattened by either.

Different analysis populations: one paper reports intention-to-treat, another emphasises completers. Different support: some trial designs include structured lifestyle contact that no member of this board receives.

Stack those and the "X beats Y" tables that circulate here are comparing five things at once and attributing the difference to the molecule.

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[removed]83 points·2 years ago

[removed by moderator]

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About c/trialwatch

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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