LEADER extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
STEP programme
Page 2 of 18 of this archive, newest first.
STEP 5 extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
Why the bone question is harder than the muscle question
A plausible mechanism, a measurable change, and no outcome data. This is what an open question looks like.
SURMOUNT-2 extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
Seasonal use, holiday use, and the honest state of the evidence
A great deal of practice has grown up around intermittent schedules. The randomised evidence for any of them is, as far as the Journal can establish, nil.
The imaging substudy is an afterthought in the protocol and the centrepiece of the debate
The trials measured mass. Nobody measured whether the participants got weaker.
SURMOUNT-4 extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
STEP 3 misses on a secondary endpoint the coverage has not mentioned
A design note rather than a result: what the comparator was, and what that permits you to conclude.
What we would need to randomise to answer this properly
One randomised trial has combined a GLP-1 receptor agonist with supervised exercise. Its result is the single most useful piece of evidence in this area.
Fat mass fell more than lean mass. That is the finding, and it is not the headline.
A substudy powered to describe a mean is not a substudy powered to detect a clinically meaningful individual change.
SURMOUNT-2 extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
STEP 8 misses on a secondary endpoint the coverage has not mentioned
A design note rather than a result: what the comparator was, and what that permits you to conclude.
FLOW extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
SURPASS-4 extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
Seasonal use, holiday use, and the honest state of the evidence
A great deal of practice has grown up around intermittent schedules. The randomised evidence for any of them is, as far as the Journal can establish, nil.
STEP 3 extension data: what happens after the trial stops
A design note rather than a result: what the comparator was, and what that permits you to conclude.
Continued treatment against continued placebo: the comparison that settled it
The regain trajectories, arm by arm, with the estimands named.
The dose that got you here and the dose that keeps you here
A survey of the maintenance evidence, which is shorter than the survey of the withdrawal evidence.
LEADER misses on a secondary endpoint the coverage has not mentioned
A design note rather than a result: what the comparator was, and what that permits you to conclude.
The advice is mostly reasonable. The certainty is not earned.
The gap between a defensible recommendation and a confident one is where most of the harm in this subject lives.