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Evidence · Journal club · continued

Journal club: SUSTAIN 6 and its retinopathy signal posts 31–60

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

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a.asanteTL26 Jul 2026#31

SUSTAIN 6: I would want to see the raw numbers rather than the summary before agreeing. Summaries lose exactly the information that would settle this.

1 like 21d
LO
l.oseiTL27 Jul 2026 · edited#32

This follows post #29 rather than contradicting it.

An observation about SUSTAIN 6 that I cannot explain and am posting anyway, on the principle that unexplained observations are more useful public than private.

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MR
m.restrepoTL27 Jul 2026#33
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ThibodeauTL3Regular7 Jul 2026#34
j.restrepo, post #20: On SUSTAIN 6 the community has more anecdote than the confidence in this thread implies, and I include my own contribution in that. Go to post

This is the sort of exchange that makes the archive worth searching.

10 likes in reply to #20 21d
EV
e.verhoevenTL27 Jul 2026#35

Adding what did not work for me on SUSTAIN 6, since the failures never get written up and they are half the useful information.

3 likes 20d
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l.solbergTL28 Jul 2026#36
HM
h.mensahTL28 Jul 2026#37

Coming back to post #35, because the follow-up matters more than the original answer.

Sessions on negative or null results are consistently the most instructive and the hardest to get anyone to attend.

The conclusion is tentative; the arithmetic underneath it is not.

30 likes 20d
LP
l.piresTL28 Jul 2026#38
m.ndiaye, post #18: 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. Go to post

The claim about SUSTAIN 6 upthread is stronger than its source supports. I have read the source. The source says "associated with" and the post says "causes".

15 likes in reply to #18 20d
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owen.bradyTL4 Moderator9 Jul 2026 · edited#39
micrograms, post #2: A note on scope: what I am saying about SUSTAIN 6 applies to the case in the first post and I would not extend it further without checking. Go to post

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.

If this contradicts something upthread, the upthread version may well be the better one.

0 likes in reply to #2 19d
MO
m.onwukaTL29 Jul 2026#40
l.osei, post #32: This follows post #29 rather than contradicting it. An observation about SUSTAIN 6 that I cannot explain and am posting anyway, on the principle that unexplained observations are more useful public than private. Go to post

Filing a mild objection to the consensus on SUSTAIN 6. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit.

23 likes in reply to #32 19d
ME
me.eriksenTL29 Jul 2026#41

Agreed on SUSTAIN 6, with one qualification that I think matters. The reasoning holds for the case as described. Change the starting assumption and it does not, and the starting assumption is the part nobody states.

2 likes 19d
ML
m.lehtinenTL29 Jul 2026#42
me.eriksen, post #41: Agreed on SUSTAIN 6, with one qualification that I think matters. The reasoning holds for the case as described. Change the starting assumption and it does not, and the starting assumption is the part nobody states. Go to post

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.

The strength of my opinion here exceeds the strength of my evidence.

9 likes in reply to #41 19d
RR
r.restrepoTL29 Jul 2026#43

Narrowing post #42, because the general version has more than one answer.

Two people in this thread mean different things by SUSTAIN 6 and are disagreeing about the definition while believing they are disagreeing about the facts. Worth pausing to define it.

29 likes 18d
CC
c.correiaTL210 Jul 2026#44

Everything in post #40 holds. The case it does not cover is the one I have.

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.

The rule of thumb is fine; the edge cases are where it earns its keep.

0 likes 18d
DO
dr_okonkwoTL4 Moderator10 Jul 2026#45

I have no financial interest in anything named in this thread and I want to say so before I comment on SUSTAIN 6, because it is the sort of subject where it matters.

1 like 18d
MP
m.perrinTL210 Jul 2026#46
j.ivaturi, post #5: What I would tell a new member reading about SUSTAIN 6 for the first time: the confident posts are not the reliable ones, and the reliable ones are longer. Go to post

Thank you — that answers what I came here to find out.

6 likes in reply to #5 18d
CC
c.cardosoTL210 Jul 2026#47
j.restrepo, post #20: On SUSTAIN 6 the community has more anecdote than the confidence in this thread implies, and I include my own contribution in that. Go to post

The arithmetic in post #45 is right; the assumption feeding it is the part to check.

Genuine question rather than a rhetorical one: has anyone here actually observed SUSTAIN 6, as opposed to read about it? The thread is long and I cannot tell.

21 likes in reply to #20 17d
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f.sjobergTL211 Jul 2026 · edited#48

Sessions on negative or null results are consistently the most instructive and the hardest to get anyone to attend.

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orbitrap_olaTL3Mass spectrometrist11 Jul 2026#49

Post #47 is the version of this I will quote in future. One addition.

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.

A weak preference rather than a position.

0 likes 17d
IA
i.almeidaTL211 Jul 2026#50

Where I part company with post #48, and it is a narrow parting.

SUSTAIN 6 is a question about a distribution, not about a value, and treating it as a value is what produces the confident wrong answers.

3 likes 17d
SC
s.cabreraTL211 Jul 2026#51
m.restrepo, post #33: Where the group cannot agree, record the disagreement rather than resolving it by seniority. The recorded disagreement is more honest and more useful later. The disagreement above is smaller than it looks once the terms are fixed. Go to post

I would rather this thread reach "we do not know" about SUSTAIN 6 than reach a confident answer that nobody can support when asked.

0 likes in reply to #33 16d
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dr_okonkwoTL4 Moderator12 Jul 2026#52

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.

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n.kuuselaTL212 Jul 2026 · edited#53

That is consistent with mine, for whatever one more account is worth.

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PharmNotes_WhitfieldTL4Pharmacist12 Jul 2026#54

Narrowing post #51, because the general version has more than one answer.

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.

Take the reasoning and check the arithmetic; I do not always get it right.

5 likes 16d
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t.pereiraTL212 Jul 2026#55

Where I part company with post #51, and it is a narrow parting.

I changed my mind about SUSTAIN 6 after someone here asked me for the source and I could not produce one. That is worth saying out loud because it is the ordinary way it happens.

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b.aaltoTL213 Jul 2026#56

Two claims get bundled together under SUSTAIN 6 and they need separating. The descriptive one — this is what was observed — is usually well supported. The causal one — this is why — usually is not.

Almost every disagreement in threads like this one dissolves once you say which of the two you are making.

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c.grimaldiTL213 Jul 2026#57

Where the group cannot agree, record the disagreement rather than resolving it by seniority. The recorded disagreement is more honest and more useful later.

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f.villalobosTL213 Jul 2026#58
c.correia, post #44: Everything in post #40 holds. The case it does not cover is the one I have. 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. The rule of thumb is fine; the edge cases are where it earns its keep. Go to post

On SUSTAIN 6, the part that usually goes wrong is that the question is asked as though it has one answer. It has a range, and the width of the range is the interesting bit.

If you can post the two or three numbers you are working from, several people here will check the arithmetic rather than argue about the conclusion.

8 likes in reply to #44 15d
YA
y.asanteTL213 Jul 2026#59

I had written a reply contradicting post #55 and deleted it. Here is what survived.

Sessions on negative or null results are consistently the most instructive and the hardest to get anyone to attend.

I am not the right person to answer the follow-up to this.

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JW
journalclub_wrenTL3Regular13 Jul 2026#60

Confirming post #59 from a second method, which matters more than confirming it from a second person.

Speaking only to SUSTAIN 6 as I have actually seen it, rather than as it is usually described: the effect is real, it is smaller than the thread suggests, and the variance between people is larger than the effect.

21 likes 14d