This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1 · go to the accepted answer.
Interactions between comorbidities: diabetes and kidney disease together change the risk calculation for hypoglycemia and for medication clearance. They are not independent variables.
If anyone can point at the primary source I would be grateful.
Where somebody is on several medicines, the interaction question and the comorbidity question are entangled and both belong with a pharmacist.
Post #31 and I disagree about the size of the effect, not about the direction.
What I would want before treating gallbladder disease risk as settled: the method, the sample, and whether anyone tried to find the opposite result. Two of the three are usually missing.
Taking post #31 at face value and following it one step further.
My experience of gallbladder disease risk contradicts the reply above. I am posting it as a data point rather than as a refutation, because one person's experience is exactly that.
Useful. I had the fact and not the reason, which turns out to be the important half.
Post #35 put the caveat in the right place and I want to underline it.
Taking gallbladder disease risk seriously for a moment rather than deflecting: the honest position is that the community has observations and no controlled comparison, and those two things support very different sentences.
Cardiovascular disease: several compounds have cardiovascular outcome trials. SELECT was in people without diabetes; SUSTAIN 6 was in high-risk diabetes. Absolute benefit is largest in high-risk people.
The claim is narrower than it sounds, and deliberately so.
Post #35 describes the usual case. This is about the unusual one.
The question underneath gallbladder disease risk 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.
Adding the measurement that post #39 says would settle it.
Small correction to my own earlier position on gallbladder disease risk. I had the units the wrong way round, which changes the conclusion by an order of magnitude and therefore changes it entirely.
Post-authorisation safety studies are the place where under-studied populations eventually appear, and they are public.
Take the reasoning and check the arithmetic; I do not always get it right.
Post #38 put the caveat in the right place and I want to underline it.
The claim about gallbladder disease risk upthread is stronger than its source supports. I have read the source. The source says "associated with" and the post says "causes".
The documentation on gallbladder disease risk is better than this thread and I say that as someone who has posted in the thread.
Multiple comorbidities: a person with diabetes, kidney disease, and cardiovascular disease is outside the studied populations in most trials. Extrapolating to that person requires reasoning from the individual component trials and mechanisms.
Anyone who has looked at this more carefully, please correct the record.
Appreciated. The plain phrasing does more work here than a longer post would.
Post-authorisation safety studies are the place where under-studied populations eventually appear, and they are public.
I had written a reply contradicting post #49 and deleted it. Here is what survived.
Having read the whole gallbladder disease risk thread before replying: the question in the first post has not actually been answered yet, and three of us have answered a nearby one instead.
Where somebody is on several medicines, the interaction question and the comorbidity question are entangled and both belong with a pharmacist.
I would keep gallbladder disease risk and the decision it usually gets used for separate in this thread. They are related and they are not the same question, and merging them is why the last one went badly.
Thank you for taking the time. That was more work than a reply usually is.
Post #53 describes the usual case. This is about the unusual one.
Multiple comorbidities: a person with diabetes, kidney disease, and cardiovascular disease is outside the studied populations in most trials. Extrapolating to that person requires reasoning from the individual component trials and mechanisms.
Cardiovascular disease: several compounds have cardiovascular outcome trials. SELECT was in people without diabetes; SUSTAIN 6 was in high-risk diabetes. Absolute benefit is largest in high-risk people.
This is the sort of thing the wiki should carry and currently does not.
Post #57 answers the question as asked. The question underneath it is different.
The practical value of this subcategory is helping somebody frame the question they take to an appointment, and that is worth being explicit about.