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ForumsPublic SquareHELP - accidentally left my vial out overnight — 6 month update Page 2

HELP - accidentally left my vial out overnight — 6 month update

SleepDoc_PDX Sat, Oct 19, 2024 at 3:16 AM 29 replies 2,242 viewsPage 2 of 6
PeptideSynthNJ
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Oct 19, 2024 at 6:11 AM#6
SleepDoc_PDX said:
Relative and absolute effects need reading together.
SleepDoc_PDX said:
...regarding the trial evidence...

I think this is an underappreciated point. To expand on it with some data:

A recent meta-analysis of 12 RCTs (n=8,400) found that the trial evidence was associated with a significant effect size across diverse patient populations[1].

The NNT was 8, which is comparable to antihypertensives for stroke reduction. That's a strong clinical argument for this approach.

2 5wanda_boise, NurseAsh_DET
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lisa_labSD
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Oct 19, 2024 at 7:19 AM#7

A narrower follow-up, since the general answer is now clear:

Was that from a primary source or from a summary of one?

3 6maya_sedona, stefan_berlin, Dr.EM_Chicago
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Dr.EndoEP
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Oct 19, 2024 at 8:27 AM#8
PeptideSynthNJ said:
SleepDoc_PDX said: ...regarding the trial evidence...

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.

4 7FranDenver, Dr.BariatricHTX, LindaRN_retired and 1 other
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SleepDoc_PDX
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Oct 19, 2024 at 9:35 AM#9

Closing the loop on my own question.

Follow-up: I read the paper rather than the summary and the qualifier I was missing was in the second paragraph of the results.

Last edited: Oct 19, 2024 at 12:35 PM
5 8sophie_paris, mel_PDX, Dr.AddMedPHL and 2 others
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bri_stats
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Oct 19, 2024 at 3:01 PM#10
Dr.EndoEP said:
Bayesian meta-analysis perspective on the trial evidence: traditional frequentist meta-analyses report point estimates and confidence intervals.

Forest plot interpretation for the the trial evidence meta-analysis: when reading the pooled estimate, pay attention to:

  1. Point estimate (HR/RR/OR) — center of the diamond
  2. Confidence interval width — precision of the estimate
  3. I² statistic — heterogeneity across studies
  4. Individual study weights — are results driven by one large trial?
  5. Prediction interval — range of plausible true effects in future settings

The the trial evidence meta-analysis shows a pooled RR of 0.74 (95% CI 0.70-0.89), I²=47%. This is a robust and consistent effect.

7 7julia.endo, JessicaM_2024, TomFromTexas and 4 others
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