Reading SURMOUNT-1 without the press release posts 61–90

Categorical response thresholds — the proportion reaching ten, fifteen or twenty per cent reduction — are more persuasive and less informative than the mean. They depend entirely on where the threshold was drawn.

I would hold that lightly until someone with a larger sample weighs in.

Confirming post #75 from a second method, which matters more than confirming it from a second person.

Reading SURMOUNT-1 without the press: I have looked for the primary source twice and failed twice. Either it does not exist or it is somewhere I do not know to look, and I would like to know which.

This settles it for me, at least until somebody posts a reason it should not.

The apnoea-hypopnoea index used in SURMOUNT-OSA is an objective measurement rather than a symptom scale, which is why that trial carries more weight than its size suggests. Two parallel trials with and without positive airway pressure addressed the obvious confounder directly.

SURMOUNT-4 used a randomised withdrawal design: everyone titrated, then those on maintenance were randomised to continue or placebo. Continuation maintained effect; withdrawal was followed by regain. The finding is robust but it says nothing about a lower effective maintenance dose, because that was not studied.

Adding a small correction to the reading SURMOUNT-1 without the press summary above rather than a disagreement with it. The substance holds; one of the figures is out by a factor that matters.

Narrowing post #80, because the general version has more than one answer.

The number people quote for reading SURMOUNT-1 without the press is a central estimate presented without its interval, and the interval is wide enough that the estimate is nearly uninformative on its own.

Categorical response thresholds — the proportion reaching ten, fifteen or twenty per cent reduction — are more persuasive and less informative than the mean. They depend entirely on where the threshold was drawn.

On reflection I would soften that slightly.

On reading SURMOUNT-1 without the press, I would rather understate and be corrected upward than overstate and be quoted. That is a house style here and it is a good one.

SURMOUNT-1 reported weight reduction of a magnitude that was the largest for a pharmacological intervention at that time of publication. It also reported a clear dose response across three doses. The categorical thresholds (people reaching 10%, 15%, 20% loss) got the most attention but read less informatively than the mean weight change.

Filing this under things that are true until someone shows me otherwise.

I read post #83 twice before replying, because I had assumed the opposite.

Filing a mild objection to the consensus on reading SURMOUNT-1 without the press. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit.

Practical experience of reading SURMOUNT-1 without the press, offered as one case with the conditions stated, not as a general finding. Conditions first, because they are what make it interpretable.

Research-use-only tirzepatide is not approved for human use and is not made to pharmaceutical standards. Anyone discussing it here is describing what they did, not recommending it.

That is the version I would defend. It is not the version I started with.

That is clearer than the version I had in my head. Thank you.

Two sentences on reading SURMOUNT-1 without the press and then I will stop, because the rest is speculation and the thread is better without mine.

What is documented is narrow. What is inferred from it is broad. The gap between them is where every argument here lives.