Adjudicated events and why the definition matters — the long version posts 121–147

Post #119 is right about the mechanism and I think understates the practical bit.

The question underneath Adjudicated events is usually "how would I tell?" rather than "what is true?", and that one has a method attached to it.

Write down what you would expect to see under each hypothesis before you collect anything. If they predict the same observation, collecting it will not help.

I would put moderate confidence on the mainstream reading of Adjudicated events and no more. That is not scepticism for its own sake; it is where the sourcing actually stops.

Absolute numbers, not just relative: a 30% relative reduction tells you the ratio but not the practical magnitude. The event rate in each arm and the difference between them tells you how many people benefit.

That is what I would do. It may not be what is correct.

Worth separating two things that post #120 runs together.

Surrogate endpoints: an endpoint that is not the outcome that matters but is measured as a stand-in. HbA1c is a surrogate for long-term glucose control and the short-term complications it prevents. Weight loss is a surrogate for metabolic health and long-term outcomes. Surrogates are useful but not identical to the endpoint that matters.

Same conclusion as the reply above, reached differently, which is mildly reassuring.

Appreciated. The plain phrasing does more work here than a longer post would.

I had written a reply contradicting post #124 and deleted it. Here is what survived.

Marking my uncertainty on Adjudicated events explicitly. I am confident about the direction, much less confident about the size, and not confident at all that it generalises past the case in the first post.

Absolute and relative effects answer different questions. Write down the event rate in each arm and the difference between them; everything quotable is derived from those two numbers.

The honest answer is that it depends, and here is what it depends on.

If someone has run Adjudicated events properly I would rather read that than my own reconstruction of it. Posting mine only because the thread has gone quiet.

For anyone finding this later: the short answer on Adjudicated events is that it depends on one thing, and the rest of the thread is people identifying which thing.

Where I part company with post #128, and it is a narrow parting.

The figure that circulates in coverage is almost always whichever estimand gives the larger effect. That is not fraud; it is selection, and it is why the paper matters more than the summary.

Reporting the observation and leaving the explanation open deliberately.

Coming back to post #127, because the follow-up matters more than the original answer.

Adjudicated events came up in a thread eighteen months ago and was answered well. I cannot find it, which is itself the problem, so here is the reconstruction.

A note on how Adjudicated events gets discussed rather than on Adjudicated events itself: the confident posts get the replies and the careful ones get ignored, and the careful ones have been right more often.

Multiplicity and multiple comparisons: if a trial tests many hypotheses, the chance of a false positive on at least one by random chance increases. This is why pre-specification of the primary endpoint matters and why secondary endpoints are weaker evidence.

A guess, clearly labelled as one.

Picking up post #131: that is the part I would want checked first.

Worth stating the null on Adjudicated events before we explain it: the observation may be nothing. That possibility deserves a sentence and usually does not get one.