Friday, November 14, 2008

Isn't it how you slice it?

From the PROactive study:
Lancet 2005 Oct 8;366(9493):1279-89

There is no significant reduction in the primary endpoint, but a reported reduction in the secondary endpoint which is a composite of all-cause mortality, non-fatal myocardial infarction and stroke.

But look at table 4: there is in fact no difference in each individual endpoint of death, non-fatal myocardial infarction (including silent MI), and stroke. Why is this?

A careful review of the article shows why. For the secondary endpoint they chose non-fatal myocardial infarction excluding silent MI. When this is thrown in you get figure 3 with an HR of 0.84 and CI of 0.72-0.98.

Does this really indicate anything significant about a reduction in macrovascular disease events when the data is manipulated in this way?

1 comment:

  1. It is funny how for the TZD, there are clear studies that show intimal regression of atherosclerosis, but yet this doesn't translate slow easily to mortality.

    I am more convinced that are current surrogates for atherosclerosis is insufficient.


Note: Only a member of this blog may post a comment.