Dr.MetabolicMD said:

The gap between trial results and real-world results is consistent and it is not fraud.

Dr.MetabolicMD has the substance of this right. The condition it depends on is worth stating. Read four things before the headline number. The population, because trial populations are selected and supported in ways that real cohorts are not. The comparator, because "better than placebo" and "better than the current standard" are different claims and get reported identically. The primary endpoint as pre-registered, because a secondary endpoint promoted after the fact is a hypothesis rather than a finding. And the completion rate, because a large effect in the half of participants who finished is a different result from a large effect in everybody enrolled.

Dr.MetabolicMD said:

The gap between trial results and real-world results is consistent and it is not fraud.

Pushing back on Dr.MetabolicMD 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.

This one has a reasonably settled answer, so here it is. Relative and absolute effects need reading together. A 20% relative reduction on a high baseline risk is a large absolute benefit; the same relative figure on a low baseline risk is a small one, and press summaries almost always quote the relative number because it is bigger.

Dr.RaviCardio said:

Read four things before the headline number.

This matches mine closely enough to be worth saying so out loud. Posting only so the count is not one.