[Discussion] TRIUMPH is doing more work than we give it credit for
The title is the argument: TRIUMPH is doing more work than we give it credit for. Here is the rest of it.
Went looking for the registered protocol to see whether the endpoint had changed. It had not, which was reassuring and worth checking.
Started keeping the trial identifiers straight in a note file because I kept mixing up two programmes in the same sentence.
Compared myself to a trial mean for about six months before realising the trial arm had dietitian contact every fortnight.
Corrections welcome, especially the pedantic ones. Pedantry is how this board earns its reputation.
best — the order this archive was captured in
Open-label extensions lose their randomisation. Anybody still enrolled at week 104 is a selected group and the numbers describe that group.
Added the trial identifier to the title so this thread is findable in two years.
Added the trial identifier to the title so this thread is findable in two years.
Disagreeing with this line: that is a relative reduction and the absolute numbers are considerably less dramatic.
Read a press release and the publication three months apart. The hedging in the second one was substantial.
How long was the randomised phase before any extension?
open-label extensions are not the same evidence as the randomised phase
Yes. The appendix tables are where the subgroup and the adverse event detail actually live.
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Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.
Disagree — that figure is from the diabetes programme and you are quoting it as an obesity endpoint.
intention to treat versus completers changes the number substantially
a mean is not a promise
discontinuation rate is a result, not a footnote
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.
the confidence interval is the finding, the point estimate is the headline
Correction: SURMOUNT is the obesity programme and SURPASS is the diabetes one. The figure you quoted belongs to the other one.
That is a relative risk reduction. Quoting it without the absolute numbers overstates the case considerably.