kate.chem said:Relative and absolute effects need reading together.
I read this differently from kate.chem, on substance rather than tone. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.
Happy to go further on any of that.
mike_mod 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…
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 0.68-0.83), I²=31%. This is a robust and consistent effect.
BethLabQueen said:I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them.
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 stroke risk (HR 0.82) 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.
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View ResultsOne thing that is still open after SarahChen_PharmD’s answer:
What would you measure differently if you were starting again?
Reporting back.
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.