My own curve sits about four points below the published mean and I spent two months assuming that meant something was wrong with me or with my material.
What I actually want to know is how to read a result like this without either dismissing it or over-reading it, since the summaries all read like press releases.
I have searched first, so if this is covered somewhere point me at it and I will read it.
Taking the question as asked, rather than the general version of it. Read four things before the headline number. The population, because trial populations are selected and supported in ways that real cohorts are not. The comparator, because "better than placebo" and "better than the current standard" are different claims and get reported identically. The primary endpoint as pre-registered, because a secondary endpoint promoted after the fact is a hypothesis rather than a finding. And the completion rate, because a large effect in the half of participants who finished is a different result from a large effect in everybody enrolled.
That is the short version; the long version is somebody else's post.
Dr.RaviCardio said:Read four things before the headline number.
Dr.RaviCardio said:...regarding the trial evidence...
I think this is an underappreciated point. To expand on it with some data:
A recent meta-analysis of 15 RCTs (n=12,300) found that the trial evidence was associated with a clinically meaningful effect size across diverse patient populations[1].
The NNT was 12, which is comparable to metformin for T2DM prevention. That's a strong clinical argument for this approach.
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View Resultsanders_CPH said:My own curve sits about four points below the published mean and I spent two months assuming that meant something was wrong with me or with my…
Can confirm the pattern anders_CPH describes. Relative and absolute effects need reading together. A 20% relative reduction on a high baseline risk is a large absolute benefit; the same relative figure on a low baseline risk is a small one, and press summaries almost always quote the relative number because it is bigger.
Adding the clinical framing, because it changes how the question reads.
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 0.76 (95% CI 0.66-0.91), I²=49%. This is a robust and consistent effect.