Questioning Medicine4 Marras 2024

Episode 342: 341. Methods Monday! What is the problem with stopping a trial EARLY?

Stopping Trials Early for Benefit: Insights From Recent Pivotal Trials in Chronic Kidney Disease - ScienceDirect

There are 4 major reasons why trials might be stopped early: 1) unequivocal benefit; 2) unacceptable harm; 3) futility; and 4) administrative reasons (enrollment or funding concerns).

trials stopped early for benefit tend to overestimate benefit, a phenomenon referred to as random-high.

trials that stopped early, especially those with <500 events, fail to provide reliable and valid estimates of treatment effect, often overestimating it by nearly 30%

Trials stopped early for harm or futility are less problematic as such data are not used to promote medications.

Published results were based on accrual of 69%, 75%, 93%, and 87% of planned events in CREDENCE, DAPA-CKD, EMPA-KIDNEY, and FLOW, respectively.

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Episode 439: 446. mRNA flu vaccine? Is it worth the outcome hype?

https://www.nejm.org/doi/full/10.1056/NEJMoa2516491https://www.ahajournals.org/doi/10.1161/CIR.0000000000001466

21 Loka 19min

Episode 438: 445. GLP1 CME

OMED GLP1 CME

14 Loka 39min

Episode 437: 444. Monday Morning Articles

Silvain J, et al. Discontinuation of β-blockers in stable patients with previous myocardial infarction, preserved left ventricular ejection fraction, and no heart failure: A pooled analysis of individ...

12 Loka 27min

Episode 436: 443. Fast 5 Medical Article Review

Kanwal F, et al. Clinical care pathway for the risk stratification and management of patients with metabolic dysfunction–associated steatotic liver disease. Gastroenterology 2026 Jul; 171:164. DOI: 10...

30 Syys 24min

Episode 435: 442. 7 article review

we unpack whether rivaroxaban followed by aspirin improves thromboprophylaxis after hip and knee arthroplasty, put oral GLP-1 therapy orforglipron head-to-head with dapagliflozin for type 2 diabetes, ...

10 Syys 33min

Episode 434: 441. Coronary Artery Calcium (CAC) -- Yacky Yack, the details on CAC

Does a Coronary Artery Calcium (CAC) scan still earn its place in modern cardiovascular prevention? This podcast cuts through the headlines to examine the recent research, challenge overconfident conc...

31 Elo 48min