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Evidence · Journal club · continued

Journal club: SURMOUNT-1, read without the press release 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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PSkarbekTL3Regular21 Dec 2024#31

SURMOUNT-1 is worth one more sentence than it usually gets, and the sentence is the one about how the number was arrived at.

4 likes 19mo
JH
j.hartmannTL223 Dec 2024 · edited#32

Adding a data point of agreement rather than a data point.

13 likes 19mo
BM
buffer_marginTL3Regular25 Dec 2024#33

Adding the measurement that post #31 says would settle it.

Having read the whole SURMOUNT-1 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.

27 likes 19mo
BR
b.restrepoTL227 Dec 2024#34
peak_purity, post #28: This follows post #25 rather than contradicting it. The documentation on SURMOUNT-1 is better than this thread and I say that as someone who has posted in the thread. Go to post

Post #30 describes the usual case. This is about the unusual one.

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.

0 likes in reply to #28 19mo
CD
c.dahlbergTL229 Dec 2024#35
buffer_margin, post #33: Adding the measurement that post #31 says would settle it. Having read the whole SURMOUNT-1 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. Go to post

Distinguishing three things in the SURMOUNT-1 discussion that keep getting used interchangeably: the observation, the proposed mechanism, and the recommendation that gets attached to both.

8 likes in reply to #33 19mo
JB
j.baptistaTL231 Dec 2024#36

The strongest argument against my own position on SURMOUNT-1, stated as well as I can state it, since nobody else has yet.

19 likes 19mo
DP
d.petrescuTL22 Jan 2025#37
IC
i.coelhoTL24 Jan 2025#38
j.erdogan, post #27: Quietly grateful for the plain phrasing. Not every thread gets that. Go to post

On post #34 — agreed on the reasoning, with one qualification.

An update on my earlier SURMOUNT-1 post: the pattern held for another six weeks and then stopped, which I did not predict and cannot explain.

0 likes in reply to #27 19mo
FK
f.kimaniTL26 Jan 2025#39

Marking my place. If it changes for me I will come back and say so.

0 likes 19mo
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KLindqvistTL4 Moderator8 Jan 2025#40

The practical version of SURMOUNT-1 is three sentences long. The rigorous version is three pages and reaches the same conclusion with the conditions attached.

5 likes 19mo
JC
j.castellanosTL210 Jan 2025#41

Post #40 put the caveat in the right place and I want to underline it.

People arriving without having read it should be welcome and should say so, because a question from someone who has not read it frequently exposes an assumption everyone else made.

Where I would look next, rather than where I would stop.

30 likes 19mo
JS
j.sorensenTL212 Jan 2025#42

I think the SURMOUNT-1 question is answerable and has not been answered, which is a more optimistic position than most of this thread.

15 likes 18mo
CR
c.rasmussenTL214 Jan 2025#43
EL
e.lokkenTL215 Jan 2025#44
dr.villanueva, post #13: 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. It cost nothing to check and would have cost something not to. Go to post

The arithmetic in post #42 is right; the assumption feeding it is the part to check.

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

0 likes in reply to #13 18mo
C
chromatogramTL4Analytical chemist17 Jan 2025#45

I would rather this thread reach "we do not know" about SURMOUNT-1 than reach a confident answer that nobody can support when asked.

0 likes 18mo
AW
a.wikstromTL219 Jan 2025#46

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

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

21 likes 18mo
JM
j.mwangiTL4 Moderator21 Jan 2025#47
m.ilunga, post #29: The bit of SURMOUNT-1 that nobody enjoys is that the answer changes depending on what you are trying to decide with it. Say what the decision is and the thread will converge. Go to post

Everything in post #44 holds. The case it does not cover is the one I have.

SURMOUNT-1 has been discussed here with more heat than it deserves, mostly because two definitions have been in play the whole time.

6 likes in reply to #29 18mo
CR
c.ramosTL223 Jan 2025#48
a.lindholm, post #19: I came in to disagree and I am leaving without a disagreement. Go to post

Narrowing post #47, because the general version has more than one answer.

A note on scope: what I am saying about SURMOUNT-1 applies to the case in the first post and I would not extend it further without checking.

1 like in reply to #19 18mo
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TL4_HalvorsenTL4Leader · Journal club25 Jan 2025#49
d.petrescu, post #37: 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. Not a strong opinion, just a consistent one. 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.

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

16 likes in reply to #37 18mo
JV
j.vogelTL226 Jan 2025#50

This follows post #47 rather than contradicting it.

Trying to state the SURMOUNT-1 position in a way that someone who disagrees would recognise as fair, because I do not think the version in this thread passes that test.

6 likes 18mo
TB
t.brandtTL228 Jan 2025#51

This follows post #50 rather than contradicting it.

Session format: read the paper before posting. The discussion is much better when everyone has. Start with the estimand and population, then methods, then results, then limitations. That order makes critique coherent.

A modest claim, modestly supported.

0 likes 18mo
KB
k.bettencourtTL2Member30 Jan 2025#52
owen.brady, post #17: What I can speak to on SURMOUNT-1 is narrow, so I will keep it narrow rather than generalising from it. Beyond that boundary I do not know. Go to post

Noted, and thank you for writing it out rather than summarising it.

1 like in reply to #17 18mo
JS
j.solbergTL21 Feb 2025 · edited#53

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 interesting part of this is the exception, and I do not understand the exception.

10 likes 18mo
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LundqvistTL2Member3 Feb 2025#54

Agreed on SURMOUNT-1, 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.

23 likes 18mo
FL
f.laurentTL24 Feb 2025#55

Taking post #54 at face value and following it one step further.

A methods point on SURMOUNT-1 rather than a substantive one: if the comparison is not like for like, the difference you are measuring is the difference in method.

32 likes 18mo
SE
septum_entryTL2Member6 Feb 2025#56
m.dalgaard, post #24: Picking up post #21: that is the part I would want checked first. Assigning the statistics to somebody who will read the analysis plan rather than the results section is worth doing in advance. It is the part that gets skipped by default. Posted with less confidence than the sentence structure implies. Go to post

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

0 likes in reply to #24 18mo
CF
c.falkTL28 Feb 2025#57
d.petrescu, post #37: 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. Not a strong opinion, just a consistent one. Go to post

The version of SURMOUNT-1 that circulates here is a simplification of a simplification. It is not wrong, but it has lost the conditions under which it holds, and those conditions are where the interesting cases live.

6 likes in reply to #37 18mo
AT
apostille_traceTL1Member10 Feb 2025#58

I read post #56 twice before replying, because I had assumed the opposite.

I have no financial interest in anything named in this thread and I want to say so before I comment on SURMOUNT-1, because it is the sort of subject where it matters.

16 likes 18mo
KC
k.chukwuTL211 Feb 2025#59
k.bettencourt, post #52: Noted, and thank you for writing it out rather than summarising it. Go to post

Agreed on all of that, and I have nothing to add to it.

24 likes in reply to #52 17mo
ZL
z.laurentTL213 Feb 2025#60