What the outcome trials measured in the kidney
Asymptomatic pancreatic enzyme elevation is common on treatment and is not pancreatitis. The distinction is clinical, not biochemical.
SELECT
The semaglutide cardiovascular outcome trial in overweight and obesity without diabetes.
What SELECT reported for HbA1c, and from which baseline
A robust, cheap, standardised assay with a specific and well-catalogued set of failure modes, several of which are common in this population.
What the trials monitored, and what that implies about routine practice
Timing is the whole of the post-cessation panel: draw it too early and it measures the treatment period.
EGFR, cystatin C, and the check on the check
What the renal and hepatic outcome programmes actually measured, and over what duration.
HbA1c and its lag: what a result three months old is telling you
The assay is not the problem. The interpretation of a lagging integral as a current measurement is the problem.
Which results are findings and which are consequences of the weight loss
A substantial proportion of the abnormal results generated during rapid weight loss are consequences of the weight loss rather than findings about the person.
What the trials monitored, and what that implies about routine practice
What the pivotal programmes measured and how often, which is a more defensible template than most published monitoring schedules.
Measuring more frequently generates more flags and not more information
What the pivotal programmes measured and how often, which is a more defensible template than most published monitoring schedules.
What the trials monitored, and what that implies about routine practice
Every additional analyte raises the probability of a flagged result and lowers the average information content of the panel.
A reference interval is not a target, and a result outside one is not a diagnosis
A twelve-analyte panel in a perfectly healthy person has roughly even odds of producing at least one flagged result.
The out-of-range flag is a statistical convention with a printer attached
A flag is a probability statement about a population. It is not a statement about the person holding the printout.
Falling ferritin is not always falling iron
A substantial proportion of the abnormal results generated during rapid weight loss are consequences of the weight loss rather than findings about the person.
What has to change before a change has happened
A flag is a probability statement about a population. It is not a statement about the person holding the printout.
What a low result means when intake has halved
Reduced intake is a plausible mechanism for deficiency. Reduced absorption is not, and the two are conflated in most of the advice.
The out-of-range flag is a statistical convention with a printer attached
Two sources of noise sit under every number: how reproducible the assay is, and how much the analyte varies within the same person on the same day.
A reference interval is not a target, and a result outside one is not a diagnosis
Two sources of noise sit under every number: how reproducible the assay is, and how much the analyte varies within the same person on the same day.
Rapid weight loss moves eight analytes for reasons that have nothing to do with the drug
A substantial proportion of the abnormal results generated during rapid weight loss are consequences of the weight loss rather than findings about the person.
Which results should be repeated before they are investigated
What the pivotal programmes measured and how often, which is a more defensible template than most published monitoring schedules.
Falling ferritin is not always falling iron
The panel drawn during a week of vomiting is measuring the vomiting.
Vitamin D, adiposity, and a volume-of-distribution problem
Reduced intake is a plausible mechanism for deficiency. Reduced absorption is not, and the two are conflated in most of the advice.