greg_boulder said:Relative and absolute effects need reading together.
Bayesian meta-analysis perspective on the trial evidence: traditional frequentist meta-analyses report point estimates and confidence intervals. Bayesian approaches provide probability distributions that are more intuitive for clinical decision-making.
For example: "There is a 98.5% probability that semaglutide 2.4mg produces >10% weight loss vs placebo" is more actionable than "RR 3.4, 95% CI 2.8-4.1, p<0.001."
The the trial evidence evidence is strong under both frameworks, but Bayesian analysis better communicates the degree of certainty for individual patient counseling.
A narrower follow-up, since the general answer is now clear:
How long did you give it before you decided it was working?
NicoleRaleigh said:Bayesian meta-analysis perspective on the trial evidence: traditional frequentist meta-analyses report point estimates and confidence intervals.
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 25,000 GLP-1 users vs matched controls showed reduced heart failure hospitalization (HR 0.74) over 5 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.
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Update — my curve sits below the published mean and the explanation is that the trial arm had support I do not have. That was reassuring rather than otherwise.
Dr.EM_Chicago said:Propensity score matching studies and the trial evidence: when RCTs aren't available for a specific question, propensity score-matched observational…
Dr.EM_Chicago said:...regarding the trial evidence...
I think this is an underappreciated point. To expand on it with some data:
A recent meta-analysis of 18 RCTs (n=15,600) found that the trial evidence was associated with a robust effect size across diverse patient populations[1].
The NNT was 15, which is comparable to statins for secondary prevention. That's a strong clinical argument for this approach.