Journal club: SUSTAIN 6 and its retinopathy signal

On the subject in the title: Journal club: SUSTAIN 6 and its retinopathy signal Working notes rather than a conclusion.

Reading SUSTAIN 6 (N Engl J Med, 2016) for the population rather than the effect, which I have not done properly before.

The baseline table is more restrictive than the way the trial gets discussed here. Several of the questions in this category come from people who would not have been enrolled.

What is the honest way to describe what the trial says to somebody outside its population?

A note on scope: what I am saying about SUSTAIN 6 applies to the case in the first post and I would not extend it further without checking.

Post #2 is right about the mechanism and I think understates the practical bit.

SUSTAIN 6 has been discussed here with more heat than it deserves, mostly because two definitions have been in play the whole time.

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

Not the answer, but possibly the question that gets there.

What I would tell a new member reading about SUSTAIN 6 for the first time: the confident posts are not the reliable ones, and the reliable ones are longer.

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.

This has been discussed before and I could not find the thread, so, again.

Confirming post #6 from a second method, which matters more than confirming it from a second person.

Adding a null result on SUSTAIN 6. I looked, carefully, and found nothing, and null results deserve posting precisely because they never are.

I had written a reply contradicting post #4 and deleted it. Here is what survived.

I think the SUSTAIN 6 question is answerable and has not been answered, which is a more optimistic position than most of this thread.

Taking post #6 at face value and following it one step further.

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.

Worth one more sentence than it usually gets.

Saving this. It is the version I will quote when the question comes round again.

Trying to state the SUSTAIN 6 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.

Adding the measurement that post #11 says would settle it.

SUSTAIN 6 is worth one more sentence than it usually gets, and the sentence is the one about how the number was arrived at.

Where I part company with post #11, and it is a narrow parting.

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.

Reporting the observation and leaving the explanation open deliberately.

Having read the whole SUSTAIN 6 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.