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ForumsOther Peptides & Research CompoundsBPC-157 actually fixed my bad knee?? Is this placebo — what worked for you?

BPC-157 actually fixed my bad knee?? Is this placebo — what worked for you?

tyler_CSCS Tue, Jun 25, 2024 at 10:27 PM 18 replies 2,233 viewsPage 1 of 4
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tyler_CSCS
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Jun 25, 2024 at 10:27 PM#1

A reference post rather than a discussion. Corrections are the point; I would rather this be right than mine. It is about the trial evidence, and it is deliberately narrow — everything I am not confident about is marked as such.

What is actually established

Relative and absolute effects need reading together. A 20% relative reduction on a high baseline risk is a large absolute benefit; the same relative figure on a low baseline risk is a small one, and press summaries almost always quote the relative number because it is bigger.

The condition it depends on

Subgroup analyses deserve particular suspicion. With enough subgroups something is significant by chance, and pre-registered subgroups are a different animal from ones found afterwards.

The practical version

A quick sanity check on any figure quoted here: is it mean or median, is it intention-to-treat or completers, and what was the comparator. Three questions, and they resolve most disagreements in these threads.

What I am not sure about

What I actually want to know is how to read a result like this without either dismissing it or over-reading it, since the summaries all read like press releases. I have searched first, so if this is covered somewhere point me at it and I will read it.

— tyler_CSCS · corrections welcome and will be edited into this post with credit
17 12sean_dublin, hannah_MT, Dr.SportsMedIN and 14 others
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BethLabQueen
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Jun 25, 2024 at 10:48 PM#2
tyler_CSCS said:
Relative and absolute effects need reading together.

tyler_CSCS has the substance of this right. The condition it depends on is worth stating. The gap between trial results and real-world results is consistent and it is not fraud. Trial participants get titration by protocol, scheduled contact, free drug and dietetic support; removing that infrastructure costs a few percentage points every time it has been measured. When your own curve sits below the published mean, that is the likeliest explanation before anything about you or your material.

16 11Dr.PulmRoch, maya_sedona, stefan_berlin and 13 others
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CarlaRPh_TPA
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Jun 25, 2024 at 11:09 PM#3
tyler_CSCS said:
Relative and absolute effects need reading together.

This is where I part company with the consensus forming above. 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.

15 10BrianDallas92, labquiet_amy, emily_PDX and 12 others
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Dr.GastroMayo
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Jun 25, 2024 at 11:30 PM#4

Taking the question as asked, rather than the general version of it. Read four things before the headline number. The population, because trial populations are selected and supported in ways that real cohorts are not. The comparator, because "better than placebo" and "better than the current standard" are different claims and get reported identically. The primary endpoint as pre-registered, because a secondary endpoint promoted after the fact is a hypothesis rather than a finding. And the completion rate, because a large effect in the half of participants who finished is a different result from a large effect in everybody enrolled.

14 9MikeFit_NJ, InsuranceTom, WendyG_ATL and 11 others
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kevin_tulsa
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Jun 26, 2024 at 1:24 AM#5
BethLabQueen said:
The gap between trial results and real-world results is consistent and it is not fraud.

Same pattern here, and in the same order. Nothing to add that would improve it.

Last edited: Jun 26, 2024 at 3:24 AM
13 8NurseLeah_Nash, gary_naperville, sean_dublin and 10 others
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