TrialNerd_Beth said:Read four things before the headline number.
Pushing back on TrialNerd_Beth here. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.
andrew_nyc said:My own curve sits about four points below the published mean and I spent two months assuming that meant something was wrong with me or with my…
Bayesian meta-analysis perspective on the trial evidence: traditional frequentist meta-analyses report point estimates and confidence intervals. Bayesian approaches provide probability distributions that are more intuitive for clinical decision-making.
For example: "There is a 98.5% probability that semaglutide 2.4mg produces >10% weight loss vs placebo" is more actionable than "RR 3.4, 95% CI 2.8-4.1, p<0.001."
The the trial evidence evidence is strong under both frameworks, but Bayesian analysis better communicates the degree of certainty for individual patient counseling.
Dr.GastroMayo said:I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them.
Dr.GastroMayo said:...regarding the trial evidence...
I think this is an underappreciated point. To expand on it with some data:
A recent meta-analysis of 22 RCTs (n=18,900) found that the trial evidence was associated with a consistent effect size across diverse patient populations[1].
The NNT was 20, which is comparable to statins for secondary prevention. That's a strong clinical argument for this approach.
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Shop Reference StandardsFollowing on from marcus_mpls — and this may be the naive question:
How long did you give it before you decided it was working?
OP back with an update, since a thread like this is useless without one.
Update — my curve sits below the published mean and the explanation is that the trial arm had support I do not have. That was reassuring rather than otherwise.