A critical appraisal, in the form of a letter to the editor, about to design and report a study that looks positive but really adds nothing to patient care.
Very interesting. First, the use of acronyms in medicine is proliferating beyond comprehension. Everything is now an acronym. You defined all of these except OS. I imagine OS is Outcome survival, but you did not define. I think all medical papers should have a glossary at the beginning or end. Then It would help to simply label the radio ligand as Pluvicto.
You also demonstrate how utterly difficult it is to truly "read" a medical scientific study. Most just snow us with an array of statistical tables. HR and CL are a misuse of outcomes. These are all relative statistics, not absolute. Statistical power and NNT are important variables.
It is well-known that 80% of all papers are defective or useless.
Thank you for raising this point. (I will look up HR and CL are; I know NNT.) I am not a scientist, doctor, stats expert or anything like that. I am just a reader and medical consumer/observer interested in learning how studies are gamed and thus people (and doctors) fooled. What I read here is often completely over my head, and yet I keep reading and learning bits and pieces here and there. (My husband has metastatic small cell lung cancer, and is so far surviving, indeed living, thanks to multiple chemo courses and brain radiation. A clinical trial could be in the future so I am on guard against any audacious control arm.)
“Writing assistance” from someone paid by the sponsor, you say…? Well that’s not sleazy or unseemly at all.
This is well outside my subject area. The summary of the pertinent treatment decisions points is appreciated.
Perhaps it’s the bias that crappy trials draw attention…but it seems oncology trials with very questionable (and ethically dubious) control arms occur more commonly than in other clinical areas.
I already do. More often than not, if it’s a sponsored study that ‘proves’ benefit, I look to see if OS improves or was even measured. If not: in the trash it goes.
This was simply another ‘massaged’ study, aimed at churning out more product. Hard pass.
Maybe after reading titles of studies we should skip ahead to see who is funding the study and then go back and read the results. Kidding..not kidding.
Very interesting. First, the use of acronyms in medicine is proliferating beyond comprehension. Everything is now an acronym. You defined all of these except OS. I imagine OS is Outcome survival, but you did not define. I think all medical papers should have a glossary at the beginning or end. Then It would help to simply label the radio ligand as Pluvicto.
You also demonstrate how utterly difficult it is to truly "read" a medical scientific study. Most just snow us with an array of statistical tables. HR and CL are a misuse of outcomes. These are all relative statistics, not absolute. Statistical power and NNT are important variables.
It is well-known that 80% of all papers are defective or useless.
This is a very important topic.
Thank you for raising this point. (I will look up HR and CL are; I know NNT.) I am not a scientist, doctor, stats expert or anything like that. I am just a reader and medical consumer/observer interested in learning how studies are gamed and thus people (and doctors) fooled. What I read here is often completely over my head, and yet I keep reading and learning bits and pieces here and there. (My husband has metastatic small cell lung cancer, and is so far surviving, indeed living, thanks to multiple chemo courses and brain radiation. A clinical trial could be in the future so I am on guard against any audacious control arm.)
OS is Overall Survival.
If abbreviations ain't your thing, you should stay away from the X-platform, it kind of drives you mad 😉
That's why I like Substack, it gives us more room to clarify without needing to sound too scientific.
Posting and discussing medical literature on X (or Twitter) is just too short IMO (In My Opinion 😘)
“Writing assistance” from someone paid by the sponsor, you say…? Well that’s not sleazy or unseemly at all.
This is well outside my subject area. The summary of the pertinent treatment decisions points is appreciated.
Perhaps it’s the bias that crappy trials draw attention…but it seems oncology trials with very questionable (and ethically dubious) control arms occur more commonly than in other clinical areas.
There is a lot of money to be gained in oncology, and more desperate patients might drive these dubious control arms...
I already do. More often than not, if it’s a sponsored study that ‘proves’ benefit, I look to see if OS improves or was even measured. If not: in the trash it goes.
This was simply another ‘massaged’ study, aimed at churning out more product. Hard pass.
Excellent appraisal by dr Develtere. Fully agree. Please also see:
https://www-nature-com.proxy-ub.rug.nl/articles/s44276-024-00065-7 and
https://www.drugdevletter.com/p/lu-psma-and-the-need-to-educate-medical
With the next one, Novartis might have some more tricks up their sleeves https://substack.com/home/post/p-174696455
Keep calling it out!!👍🏻
Maybe after reading titles of studies we should skip ahead to see who is funding the study and then go back and read the results. Kidding..not kidding.