Journal club: indirect comparison between two programmes, defended and attacked posts 121–132

What I would tell a new member reading about indirect comparison for the first time: the confident posts are not the reliable ones, and the reliable ones are longer.

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.

Adding the measurement that post #122 says would settle it.

An update on my earlier indirect comparison post: the pattern held for another six weeks and then stopped, which I did not predict and cannot explain.

Post #120 describes the usual case. This is about the unusual one.

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.

I would want a second opinion before relying on that.

Critical appraisal template: (1) What did the trial set out to estimate? (2) Could the design answer that question? (3) Was the population sufficiently similar to your population to apply the results? (4) What was the absolute effect, not just the relative one? (5) What are the two strongest criticisms available?

Indirect comparison sits at the boundary between what this community can usefully discuss and what it cannot, and I think it falls on the discussable side, narrowly.

Reading rather than answering, but this is the post I would point somebody at.

Indirect comparison is worth one more sentence than it usually gets, and the sentence is the one about how the number was arrived at.

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.

Reading it again, the caveat matters more than the finding.

Grateful for the specificity. Vague answers to this question are what sent me looking.

Coming back to post #128, because the follow-up matters more than the original answer.

An hour is enough for one paper read properly and not enough for two read partly. The temptation is always to add the second.

That distinction has done more work for me than anything else in this category.

Post #131 is right about the mechanism and I think understates the practical bit.

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.