GenomicsKate said:Relative and absolute effects need reading together.
GenomicsKate 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 statins for secondary prevention. That's a strong clinical argument for this approach.
Following on from pete_nash — and this may be the naive question:
How long did you give it before you decided it was working?
Dr.PeteFamMed said:GenomicsKate said: ...regarding the trial evidence...
Forest plot interpretation for the the trial evidence meta-analysis: when reading the pooled estimate, pay attention to:
- Point estimate (HR/RR/OR) — center of the diamond
- Confidence interval width — precision of the estimate
- I² statistic — heterogeneity across studies
- Individual study weights — are results driven by one large trial?
- Prediction interval — range of plausible true effects in future settings
The the trial evidence meta-analysis shows a pooled RR of 0.73 (95% CI 0.65-0.88), I²=46%. This is a robust and consistent effect.
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View ResultsOP back with an update, since a thread like this is useless without one.
Follow-up: I read the paper rather than the summary and the qualifier I was missing was in the second paragraph of the results.
PharmHunterJen said:Forest plot interpretation for the the trial evidence meta-analysis: when reading the pooled estimate, pay attention to: Point estimate (HR/RR/OR) —…
Propensity score matching studies and the trial evidence: when RCTs aren't available for a specific question, propensity score-matched observational studies can provide useful evidence.
A recent PSM study of 18,000 GLP-1 users vs matched controls showed reduced heart failure hospitalization (HR 0.74) over 4 years of follow-up[1].
These results complement the RCT data and suggest the benefits translate to real-world populations.
[1] Registry-based cohort study, pre-print 2024.