From vial to bench: what is recorded and what is assumed
Chain of custody, in a regulated setting, begins at sampling. Here it begins when the package arrives.
The Ledger
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Spain caps semaglutide prescribing to 20 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
Two-thirds back: the extension nobody expected to be the headline
The regain trajectories, arm by arm, with the estimands named.
India declines to reimburse dulaglutide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
Canada caps dulaglutide prescribing to 3 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
What STEP 3 tells us about maintenance, and what it does not
Every withdrawal trial compared full dose against nothing. The clinically interesting comparison — full dose against a reduced one — has not been randomised.
Turkey declines to reimburse semaglutide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
Japan caps exenatide prescribing to 9 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
The shortage years, and what they taught about interruption
Cost is the modal reason for discontinuation in every dataset we have seen, and it is absent from the clinical literature.
Argentina caps liraglutide prescribing to 4 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
The badge economy, and what it is actually certifying
Every step between the laboratory report and the product page removes information, and the badge is the last step.
Mexico declines to reimburse exenatide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
What the placebo arms of the withdrawal trials actually tell us
Three randomised withdrawal designs have tested what happens when treatment stops. Their results are consistent and they are consistently misreported.
South Korea declines to reimburse tirzepatide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
New Zealand declines to reimburse semaglutide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
A tested vial is evidence about a vial
What a laboratory can and cannot know about the provenance, storage history and representativeness of what lands on its bench.
Nigeria caps semaglutide prescribing to 12 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
Brazil caps liraglutide prescribing to 18 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
Italy declines to reimburse liraglutide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
The submitted sample: the weakest link in the whole system
The condition on arrival is recorded by some services and not others, and it is one of the more informative lines in a report.