Journal club: SELECT, absolute risk, and how it was reported

Journal club: SELECT, absolute risk, and how it was reported Writing it up because I had to work it out twice and would rather nobody else did.

A question about what the numbers mean rather than what they are.

SELECT (N Engl J Med, 2023) reports its primary result in relative terms, and the absolute figures are in a table two pages later. The two produce very different impressions of the same finding.

I would like to work through which one belongs in a summary, and why the answer is not simply "both".

SELECT (N Engl J Med 2023): Semaglutide cardiovascular outcomes without diabetes. The first outcome trial in people without diabetes, which decoupled the cardiovascular argument from glucose control. Read the absolute numbers, not just the relative reduction.

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

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

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?