[Discussion] TRIUMPH is doing more work than we give it credit for
Posting this as a discussion rather than a claim: TRIUMPH is doing more work than we give it credit for.
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.
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.
Argued for a week about a result and then read the limitations section, which conceded most of my opponent’s point.
Ask me anything specific. Anything general I will probably get wrong.
best — the order this archive was captured in
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.
the appendix is where the interesting tables live
registry entry, protocol, publication — three different documents
Same. A press release is a claim about a result; the publication is the result.
the confidence interval is the finding, the point estimate is the headline
registry entry, protocol, publication — three different documents
This is the distinction that would end about half the arguments on this board.
Started keeping the trial identifiers straight in a note file because I kept mixing up two programmes in the same sentence.