[Question] how do you actually verify SURPASS
how do you actually verify SURPASS. I would rather ask a basic question now than get this wrong quietly for two months.
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.
Sceptical readings welcome. The confident ones are the ones I distrust.
best — the order this archive was captured in
Relative risk reduction without the baseline rate is uninterpretable. A large relative reduction on a small absolute risk is a small absolute benefit.
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.
Small fix — that was the cardiovascular outcomes trial, so weight was a secondary endpoint and the population was different.
trial populations get support that nobody on this board gets
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registry entry, protocol, publication — three different documents
discontinuation rate is a result, not a footnote
Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.
Added the trial identifier to the title so this thread is findable in two years.
FLOW was kidney outcomes and it is the one nobody quotes
SELECT was cardiovascular outcomes, not weight
STEP is semaglutide obesity, SURMOUNT is tirzepatide obesity, they are not interchangeable
Went looking for the registered protocol to see whether the endpoint had changed. It had not, which was reassuring and worth checking.
Is that intention-to-treat or completers?
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.
Read a press release and the publication three months apart. The hedging in the second one was substantial.
Read a press release and the publication three months apart.
Adding the check nobody runs — the registered protocol is public and takes two minutes to compare.
Compared myself to a trial mean for about six months before realising the trial arm had dietitian contact every fortnight.
Agreed on comparators. "Superior" means nothing until you know superior to what and at what dose.
Same. A press release is a claim about a result; the publication is the result.
a mean is not a promise
phase 2 finds a dose, phase 3 measures the effect
intention to treat versus completers changes the number substantially
That is the 68-week readout, not the 72-week one. Different trial, different duration.
read the endpoint before you read the headline
Not convinced. Cross-trial comparison between two programmes with different populations and designs is not a comparison.
Do you have the publication or the press release?
Yes — the interval is the finding. A point estimate with a wide interval is a hypothesis in a nice font.
- 1Same. A press release is a claim about a result; the publication is the…10 comments in this branch · started by u/prior_auth_pain
- 2The registered protocol is public. Comparing the registered primary endpoint…7 comments in this branch · started by u/first_hundred