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Evidence · Study critique

Coming back to: Measurement error in a self-reported exposure

1 hidden by flag
LA
l.aguirreTL2 Moderator17 Apr 2026#1

Measurement error in a self-reported exposure — setting out what I have, and where I think it stops being reliable.

I have seen FLOW (N Engl J Med, 2024) cited in support of a claim I do not think it supports, twice this month, so I would like to work through what it actually shows.

My reading is that the trial is sound for its own question and is being stretched to answer a different one. I might be wrong about that, which is why this is a topic rather than a correction.

What I would like from this discussion: someone who disagrees with me to say why, with the section of the paper they are relying on.

18 likes 3mo
RN
r.novakTL2 Moderator18 Apr 2026#2

Bias towards the null and bias away from the null: different criticisms have different directions. Differential dropout might bias away from null; conservative statistical analysis might bias toward null.

2 likes 3mo
OA
o.abrahamsenTL3Regular19 Apr 2026#3
l.aguirre, post #1: Measurement error in a self-reported exposure — setting out what I have, and where I think it stops being reliable. I have seen FLOW ( N Engl J Med , 2024) cited in support of a claim I do not think it supports, twice this month, so I would like to work through what it actually shows. My reading is that the trial is sound for its own… Go to post

Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive.

0 likes in reply to #1 3mo
KA
k.adeyemiTL219 Apr 2026#4
CD
cannula_driftTL320 Apr 2026#5
SV
sa.vogelTL2 Moderator20 Apr 2026#6

I disagree with the reply above, and I think the disagreement is substantive rather than terminological.

The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.

1 like 3mo
BR
buffer_reviewTL3Regular21 Apr 2026#7

Defending a paper against criticism: if the authors respond, they might clarify something the paper explained poorly. Their response might also miss your point. Either way, the exchange in public is more useful than quiet disagreement.

0 likes 3mo
HB
h.bhattacharyaTL2 Moderator21 Apr 2026#8
buffer_review, post #7: Defending a paper against criticism: if the authors respond, they might clarify something the paper explained poorly. Their response might also miss your point. Either way, the exchange in public is more useful than quiet disagreement. Go to post

Building consensus on which criticisms matter: if everyone agrees that the sample size is small but only you think that affects the conclusion, maybe your criticism is more idiosyncratic. That does not make it wrong but it is worth noticing.

22 likes in reply to #7 3mo
MC
m.coelhoTL2 Moderator22 Apr 2026#9

Coming back to post #7, because the follow-up matters more than the original answer.

Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive.

3 likes 3mo
BV
b.vestergaardTL2 Moderator22 Apr 2026#10

Picking up post #7: that is the part I would want checked first.

What makes a methodological criticism substantive: it identifies a specific feature of the design that materially affects what the paper can conclude. "Small sample size" alone is weak. "Small sample size for a rare outcome, so the confidence interval is wide" is stronger.

0 likes 3mo
T
ThibodeauTL3Regular22 Apr 2026#11

Multiple comparisons: if a paper reports many outcomes, the chance of a spurious association by random chance is real. Pre-specification of primary outcomes matters and secondary analyses are weaker evidence.

32 likes 3mo
HA
h.amankwahTL223 Apr 2026#12
CI
c.inglethorpeTL3Regular23 Apr 2026#13
h.amankwah, post #12: Coming back to post #10, because the follow-up matters more than the original answer. When you change your mind: if a reply convinces you that your criticism was not well-founded, say so plainly. The critique might still be real but smaller than you originally thought. That is not a failure — it is how discussion works. Go to post

post #12 answers the question as asked. The question underneath it is different.

Criticise the method, not the author: a paper with a weak design is not a bad paper by someone with bad intentions. It is a paper that answers a limited question. Sometimes that is what the sponsor wanted, sometimes the researchers did the best they could with constraints.

3 likes in reply to #12 3mo
FC
f.chowdhuryTL2 Moderator24 Apr 2026 · edited#14
o.abrahamsen, post #3: Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive. Go to post

Generalisability: do the inclusion/exclusion criteria narrow the population so much that results do not apply to real people asking about it? This is a fair criticism but requires specificity about which real people and why the difference matters.

11 likes in reply to #3 3mo
C
CSagredoTL3Regular24 Apr 2026#15

This follows post #12 rather than contradicting it.

I disagree with the reply above, and I think the disagreement is substantive rather than terminological.

The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.

24 likes 3mo
RM
r.molnarTL2 Moderator25 Apr 2026#16

I read post #14 twice before replying, because I had assumed the opposite.

When you change your mind: if a reply convinces you that your criticism was not well-founded, say so plainly. The critique might still be real but smaller than you originally thought. That is not a failure — it is how discussion works.

0 likes 3mo
F
FFaulknerTL3Regular25 Apr 2026#17

Choosing the worst interpretation: "The confidence interval includes a harmful effect" is true if the CI goes from -1 to +5. But assuming the worst-case scenario is not how you use the evidence. The point estimate and the precision both matter.

1 like 3mo
HR
h.ramosTL2 Moderator25 Apr 2026#18
sa.vogel, post #6: I disagree with the reply above, and I think the disagreement is substantive rather than terminological. The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient. Go to post

Publication bias: a single published positive trial is weaker evidence than multiple published trials with consistent results. Asking whether there are unpublished negative trials is a fair critical question.

7 likes in reply to #6 3mo
GR
g.rasmussenTL2 Moderator26 Apr 2026#19

Picking up post #16: that is the part I would want checked first.

Generalisability: do the inclusion/exclusion criteria narrow the population so much that results do not apply to real people asking about it? This is a fair criticism but requires specificity about which real people and why the difference matters.

0 likes 3mo
MP
mira.patelTL4 Admin26 Apr 2026#20

Coming back to post #18, because the follow-up matters more than the original answer.

What makes a methodological criticism substantive: it identifies a specific feature of the design that materially affects what the paper can conclude. "Small sample size" alone is weak. "Small sample size for a rare outcome, so the confidence interval is wide" is stronger.

3 likes 3mo
RM
r.marsdenTL3Regular26 Apr 2026#21

Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive.

0 likes 3mo
FF
f.fontaineTL2 Moderator27 Apr 2026#22

Picking up post #19: that is the part I would want checked first.

Bias towards the null and bias away from the null: different criticisms have different directions. Differential dropout might bias away from null; conservative statistical analysis might bias toward null.

24 likes 3mo
P
PSundbergTL2Member27 Apr 2026#23
f.chowdhury, post #14: Generalisability: do the inclusion/exclusion criteria narrow the population so much that results do not apply to real people asking about it? This is a fair criticism but requires specificity about which real people and why the difference matters. Go to post

On post #19 — agreed on the reasoning, with one qualification.

Confounding: in observational data, is there a third variable that explains the apparent association? In randomised data, randomisation should balance unknown confounders, though known confounders can be adjusted for.

7 likes in reply to #14 3mo
YE
y.eriksenTL2 Moderator28 Apr 2026#24

Multiple comparisons: if a paper reports many outcomes, the chance of a spurious association by random chance is real. Pre-specification of primary outcomes matters and secondary analyses are weaker evidence.

1 like 3mo
KF
k.farrugiaTL3Regular28 Apr 2026#25

Building consensus on which criticisms matter: if everyone agrees that the sample size is small but only you think that affects the conclusion, maybe your criticism is more idiosyncratic. That does not make it wrong but it is worth noticing.

0 likes 3mo
CB
c.balogunTL2 Moderator28 Apr 2026#26

This follows post #23 rather than contradicting it.

I disagree with the reply above, and I think the disagreement is substantive rather than terminological.

The distinction being drawn does not survive when you look at the published data for this specific question. I would be glad to be shown wrong on this, because the version I am arguing against is more convenient.

32 likes 3mo
L
LeitermanTL3Regular29 Apr 2026#27
g.rasmussen, post #19: Picking up post #16: that is the part I would want checked first. Generalisability: do the inclusion/exclusion criteria narrow the population so much that results do not apply to real people asking about it? This is a fair criticism but requires specificity about which real people and why the difference matters. Go to post

Defending a paper against criticism: if the authors respond, they might clarify something the paper explained poorly. Their response might also miss your point. Either way, the exchange in public is more useful than quiet disagreement.

11 likes in reply to #19 3mo
NS
n.serranoTL2 Moderator29 Apr 2026#28
f.chowdhury, post #14: Generalisability: do the inclusion/exclusion criteria narrow the population so much that results do not apply to real people asking about it? This is a fair criticism but requires specificity about which real people and why the difference matters. Go to post

Criticise the method, not the author: a paper with a weak design is not a bad paper by someone with bad intentions. It is a paper that answers a limited question. Sometimes that is what the sponsor wanted, sometimes the researchers did the best they could with constraints.

3 likes in reply to #14 3mo

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