I keep finding that the number in the press summary and the number in the paper are not the same number, and the difference is always in the same direction.
So the question, as narrowly as I can put it: how to read a result like this without either dismissing it or over-reading it, since the summaries all read like press releases.
If the honest answer is that nobody knows, that is a useful answer and I would rather have it.
Short answer first, then the reasoning. 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.SportsMedIN said:Read four things before the headline number.
Dr.SportsMedIN 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 antihypertensives for stroke reduction. That's a strong clinical argument for this approach.
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View Resultsnick_newbie said:I keep finding that the number in the press summary and the number in the paper are not the same number, and the difference is always in the same…
Can confirm the pattern nick_newbie 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.
Clinical perspective, offered as context rather than as advice.
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 0.80 (95% CI 0.69-0.90), I²=38%. This is a robust and consistent effect.