Dr.AddMedPHL said:

Read four things before the headline number.

Pushing back on Dr.AddMedPHL here. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

raj_cambridge said:

I keep finding that the number in the press summary and the number in the paper are not the same number, and the difference is always in the same…

raj_cambridge said:

...regarding the trial evidence...

I think this is an underappreciated point. To expand on it with some data:

A recent meta-analysis of 12 RCTs (n=8,400) found that the trial evidence was associated with a significant effect size across diverse patient populations[1].

The NNT was 8, which is comparable to statins for secondary prevention. That's a strong clinical argument for this approach.

mike_nyc said:

I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them.

Forest plot interpretation for the the trial evidence meta-analysis: when reading the pooled estimate, pay attention to:

1. Point estimate (HR/RR/OR) — center of the diamond
2. Confidence interval width — precision of the estimate
3. I² statistic — heterogeneity across studies
4. Individual study weights — are results driven by one large trial?
5. Prediction interval — range of plausible true effects in future settings

The the trial evidence meta-analysis shows a pooled RR of 0.76 (95% CI 0.68-0.91), I²=49%. This is a robust and consistent effect.

Following on from Dr.PainCLE — and this may be the naive question:

How would you tell the difference between that and the alternative explanation?

OP back with an update, since a thread like this is useless without one.

Update — my curve sits below the published mean and the explanation is that the trial arm had support I do not have. That was reassuring rather than otherwise.