DebRD_ATL said:The gap between trial results and real-world results is consistent and it is not fraud.
This answered a question I did not know how to ask.
From the other side of the consultation, briefly.
MASHdoc_SA said:...regarding the trial evidence...
I think this is an underappreciated point. To expand on it with some data:
A recent meta-analysis of 15 RCTs (n=12,300) found that the trial evidence was associated with a clinically meaningful effect size across diverse patient populations[1].
The NNT was 12, which is comparable to metformin for T2DM prevention. That's a strong clinical argument for this approach.
SarahChen_PharmD said:The liver data is among the strongest non-weight findings in the class.
Forest plot interpretation for the the trial evidence meta-analysis: when reading the pooled estimate, pay attention to:
The the trial evidence meta-analysis shows a pooled RR of 0.78 (95% CI 0.66-0.83), I²=51%. This is a robust and consistent effect.
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View ResultsMASHdoc_SA said:Read four things before the headline number.
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.
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