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c/trialwatch·posted 4 days ago by u/britta_boateng

[Stats] relative risk reduction sells papers, absolute risk reduction makes decisions

Stats Clean Column ×1

relative risk reduction sells papers, absolute risk reduction makes decisions. It is the sort of thing everyone half-believes and nobody writes down.

The discontinuation numbers were the most useful thing in the paper for me and they were in a supplementary table.

Argued for a week about a result and then read the limitations section, which conceded most of my opponent’s point.

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.

If two or three other people have done the same thing we might actually learn something. Alone it is an anecdote.

803 up / 72 down92% upvoted58 commentsid poxn9625 Jul 2026

58 comments

25 in this archive, depth 6

best — the order this archive was captured in

u/oskar_ibarra71 points·2 days ago

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.

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u/week_one_wanda56 points·2 days ago

Yes — the interval is the finding. A point estimate with a wide interval is a hypothesis in a nice font.

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u/plateau_patrol27 points·2 days ago

read the endpoint before you read the headline

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u/pancreatitis_scare20 points·2 days ago

Agreed on comparators. "Superior" means nothing until you know superior to what and at what dose.

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u/hedda_adeyemi27 points·2 days ago

Went looking for the registered protocol to see whether the endpoint had changed. It had not, which was reassuring and worth checking.

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u/nightowl_injector12 points·2 days ago

SELECT was cardiovascular outcomes, not weight

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u/customs_seizure_sid6 points·2 days ago

open-label extensions are not the same evidence as the randomised phase

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u/rania_salinas4 points·1 days ago

open-label extensions are not the same evidence as the randomised phase

customs_seizure_sid is right about the programme names. They are different populations with different endpoints.

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u/formulary_fighterappeals1 point·1 days ago

Disagree — that figure is from the diabetes programme and you are quoting it as an obesity endpoint.

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u/tb500_tangent39 points·4 days ago

This. Intention-to-treat versus completer analysis routinely moves the headline by several points.

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u/britta_boatengOP26 points·4 days ago

SURPASS is the diabetes programme and reports glycaemic endpoints

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u/piotr_bruun11 points·4 days ago

Do you have the publication or the press release?

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u/tb500_tangent27 points·4 days ago

Correction: SURMOUNT is the obesity programme and SURPASS is the diabetes one. The figure you quoted belongs to the other one.

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u/eu_apotheke_a32 points·3 days ago

Small fix — that was the cardiovascular outcomes trial, so weight was a secondary endpoint and the population was different.

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u/hub_opssite staff22 points·3 days ago

discontinuation rate is a result, not a footnote

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u/hamza_zielinski33 points·4 days ago

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

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u/line_demir33 points·3 days 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/forest_plot_fionaMOD20 points·4 days ago

Retitled: the original quoted a diabetes endpoint as an obesity result.

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u/ferran_dahlberg8 points·4 days ago

Which trial, and which arm?

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u/hazard_ratio_halstats13 points·3 days ago

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.

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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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