Dr.BariatricHTX said:The gap between trial results and real-world results is consistent and it is not fraud.
This answered a question I did not know how to ask.
Clinical perspective, offered as context rather than as advice.
Dr.MetabolicMD 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 metformin for T2DM prevention. That's a strong clinical argument for this approach.
pete_nash said:Bayesian meta-analysis perspective on the trial evidence: traditional frequentist meta-analyses report point estimates and confidence intervals.
This is where I part company with the consensus forming above. Not convinced. The evidence being cited is consistent with the conclusion and also consistent with two other conclusions nobody has ruled out.
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Shop Reference StandardsOne concrete data point for the thread. For anyone reading later: the numbers in this thread are worth checking against a primary source before you act on them, including mine. Half the figures circulating in this community trace back to a secondary summary that dropped a qualifier.