three years of SURMOUNT threads, summarised so you do not have to read them
Posting this as a discussion rather than a claim: three years of SURMOUNT threads, summarised so you do not have to read them. Relative risk reduction without the baseline rate is uninterpretable. A large relative reduction on a small absolute risk is a small absolute benefit. Open-label extensions lose their…
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.
Disagree — that figure is from the diabetes programme and you are quoting it as an obesity endpoint.
The discontinuation numbers were the most useful thing in the paper for me and they were in a supplementary table.
STEP is semaglutide obesity, SURMOUNT is tirzepatide obesity, they are not interchangeable
the confidence interval is the finding, the point estimate is the headline
Push back: an open-label extension tells you about the people who stayed. That is a different question.
Agreed on comparators. "Superior" means nothing until you know superior to what and at what dose.
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.
This. Intention-to-treat versus completer analysis routinely moves the headline by several points.