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c/trialwatch·posted 9 months ago by u/blunt_coldbox_notes

[Meta] the FLOW rule is doing its job and people should stop complaining

Readout Clean Column ×6

the FLOW rule is doing its job and people should stop complaining. Nothing about this affects the ranking maths, before anyone asks.

Started keeping the trial identifiers straight in a note file because I kept mixing up two programmes in the same sentence.

Quoted a figure here confidently, got asked whether it was ITT, went and checked, and it was not. Learned something.

Read a press release and the publication three months apart. The hedging in the second one was substantial.

Please do not ask me what dose you should be on. I genuinely do not know and neither does anyone else here.

1,024 up / 308 down77% upvoted44 commentsid sxlhs22 Oct 2025

44 comments

23 in this archive, depth 5

best — the order this archive was captured in

u/week_one_wanda80 points·9 months ago

What was the discontinuation rate?

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u/naomi_ekstrom21 points·9 months 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/blunt_coldbox_notesOP11 points·9 months ago

Do you have the publication or the press release?

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u/renal_outcomes_rMOD46 points·9 months ago

Press-release posts get their own flair here. Nothing wrong with them, they are just a different kind of claim.

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u/pancreatitis_scare51 points·9 months ago

Absolute or relative risk reduction?

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u/blunt_coldbox_notesOP31 points·9 months ago

the appendix is where the interesting tables live

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u/ahmed_iyer0 points·9 months 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/cesar_ivaturi1 point·9 months ago

Relative risk reduction without the baseline rate is uninterpretable.

Adding the check nobody runs — the registered protocol is public and takes two minutes to compare.

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u/valeria_karlsen1 point·9 months ago

Compared myself to a trial mean for about six months before realising the trial arm had dietitian contact every fortnight.

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u/gastric_emptying_g21 points·9 months ago

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.

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u/eu_apotheke_a6 points·9 months ago·edited

Not convinced. Cross-trial comparison between two programmes with different populations and designs is not a comparison.

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u/nora_oyelaran3 points·9 months 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/receptor_bias_rick1 point·9 months ago

Which trial, and which arm?

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u/nora_oyelaran1 point·9 months ago

Yes. The appendix tables are where the subgroup and the adverse event detail actually live.

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u/anders_vermeulen2 points·9 months ago

How long was the randomised phase before any extension?

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u/hedda_adeyemi3 points·9 months ago

a mean is not a promise

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u/blunt_coldbox_notesOP0 points·9 months ago

What did the confidence interval look like?

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u/hedda_adeyemi0 points·9 months ago

Spent an evening with the appendix tables and found the subgroup detail that the entire thread had been speculating about.

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u/nightowl_injector12 points·9 months ago

the confidence interval is the finding, the point estimate is the headline

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u/karl_fischer_kev4 points·9 months 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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u/cesar_ivaturi2 points·9 months ago

FLOW was kidney outcomes and it is the one nobody quotes

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u/marit_laurent-9 points·9 months 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/hugo_norgaard1 point·9 months ago

trial populations get support that nobody on this board gets

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