[2026 update] Journal club: is percentage weight change the right endpoint? posts 31–60
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
The baseline characteristics table is the single most useful page for the questions that get asked here, because it tells you who the result applies to.
That is all I can say without guessing.
STEP 1 (N Engl J Med 2021): The pivotal obesity trial for semaglutide and the reference point for most subsequent comparison. Mean weight reduction was substantially larger than anything previously achieved pharmacologically.
That distinction has done more work for me than anything else in this category.
Where the group cannot agree, record the disagreement rather than resolving it by seniority. The recorded disagreement is more honest and more useful later.
Sessions on negative or null results are consistently the most instructive and the hardest to get anyone to attend.
I would rather say I do not know than round it up to an answer.
SURMOUNT-OSA (N Engl J Med 2024): Tirzepatide in obstructive sleep apnoea, using an objective physiological endpoint. Notable because soft endpoints are avoided. Two parallel trials addressed the confounder directly.
The conclusion is tentative; the arithmetic underneath it is not.
Post #35 and I disagree about the size of the effect, not about the direction.
The figures usually contain the finding and the text usually contains the interpretation. Separating them for the first twenty minutes is a discipline worth keeping.
Flagging that the sources on this are thinner than the confidence in the thread suggests.
Taking post #39 at face value and following it one step further.
STEP 1 (N Engl J Med 2021): The pivotal obesity trial for semaglutide and the reference point for most subsequent comparison. Mean weight reduction was substantially larger than anything previously achieved pharmacologically.
The most common failure mode is spending fifty minutes on the effect size and ten on the population. Reversing that ratio would improve most sessions.
It is worth stating the boring hypothesis before the interesting one.
Reading order that works for these sessions: registry entry, methods, baseline table, primary result, then abstract last. Reading the abstract first anchors everything that follows.
Not disagreeing with anyone above, just adding the bit I keep having to look up.
The figures usually contain the finding and the text usually contains the interpretation. Separating them for the first twenty minutes is a discipline worth keeping.
Adding a source would improve this post and I do not have one to hand.
Post #42 and I disagree about the size of the effect, not about the direction.
Sessions on negative or null results are consistently the most instructive and the hardest to get anyone to attend.
Not the answer, but possibly the question that gets there.
Post #44 answers the question as asked. The question underneath it is different.
The baseline characteristics table is the single most useful page for the questions that get asked here, because it tells you who the result applies to.
It is worth checking rather than assuming, which costs nothing.
Where the group cannot agree, record the disagreement rather than resolving it by seniority. The recorded disagreement is more honest and more useful later.
This has been discussed before and I could not find the thread, so, again.
Worth separating two things that post #46 runs together.
Reading order that works for these sessions: registry entry, methods, baseline table, primary result, then abstract last. Reading the abstract first anchors everything that follows.
The baseline characteristics table is the single most useful page for the questions that get asked here, because it tells you who the result applies to.
Agreed, and I will stop repeating the version of this I had been repeating.
I read post #49 twice before replying, because I had assumed the opposite.
Sessions on negative or null results are consistently the most instructive and the hardest to get anyone to attend.
I would call that likely rather than established.
The baseline characteristics table is the single most useful page for the questions that get asked here, because it tells you who the result applies to.
None of the above is medical advice and I am not qualified to give any.
SURMOUNT-1 (N Engl J Med 2022): Tirzepatide obesity trial. The largest mean weight reduction for a pharmacological intervention at publication. Read the categorical thresholds carefully — they can exaggerate separation.
If anyone can point at the primary source I would be grateful.
The figures usually contain the finding and the text usually contains the interpretation. Separating them for the first twenty minutes is a discipline worth keeping.
Everything in post #53 holds. The case it does not cover is the one I have.
Reading order that works for these sessions: registry entry, methods, baseline table, primary result, then abstract last. Reading the abstract first anchors everything that follows.
The general case is well covered; this is the awkward specific one.
Narrowing post #57, because the general version has more than one answer.
The most common failure mode is spending fifty minutes on the effect size and ten on the population. Reversing that ratio would improve most sessions.
That is the shape of it. The detail is where I would expect to be corrected.
Where the group cannot agree, record the disagreement rather than resolving it by seniority. The recorded disagreement is more honest and more useful later.
That is the practical version. The rigorous version is longer and says the same thing.
The figures usually contain the finding and the text usually contains the interpretation. Separating them for the first twenty minutes is a discipline worth keeping.
Happy to be corrected if someone holds better data than mine.