Evidence synthesis · §4
Percentage weight change as a surrogate outcome — summary of findings
Outcome-by-outcome summary with effect, certainty and the reason for each downgrade.
§4Summary of findings
§4.1Summary of findings
Table 7. Summary of findings for Percentage weight change as a surrogate outcome.
| Outcome | Participants (studies) | Effect as reported | Certainty | Reason for downgrade |
|---|---|---|---|---|
| Percentage change in body weight from baselineThe outcome the Institute designates as anchor for this indication. | 34,324 (24) | Low certainty evidence indicates that percentage weight change is an imperfect surrogate | Low | risk of bias, publication bias |
| Discontinuation for adverse eventsReported as a summary-of-findings row rather than in a tolerability annex, following a public submission. | 27,586 (24) | Reported per contributing trial; see the included-studies table | Low | inconsistency |
| Serious adverse eventsEvent counts are low; the estimate is imprecise by construction. | 29,039 (22) | Reported per contributing trial; see the included-studies table | Very low | inconsistency, publication bias |
| Any adverse eventAscertained by spontaneous report in the contributing trials. | 25,676 (22) | Reported per contributing trial; see the included-studies table | Very low | imprecision, publication bias |
| Proportion achieving ≥5 %, ≥10 %, ≥15 % and ≥20 % weight reductionA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it. | 26,707 (23) | Reported as a secondary outcome in a subset of contributing trials | Very low | inconsistency, indirectness |
| Change in waist circumferenceA secondary outcome for this indication. Its hierarchical position within each contributing trial is recorded on that trial's abstract where the Institute holds it. | 24,238 (23) | Reported as a secondary outcome in a subset of contributing trials | Very low | risk of bias, indirectness |
| Certainty ratings describe confidence in the effect estimate for the stated outcome. They are not recommendations and do not transfer between outcomes. | ||||
§4.2Forest plot
Study estimatePooled estimate
§4.3Certainty assessment for the anchor outcome
Table 8. Reasoning recorded against each certainty domain for the anchor outcome.
| Domain | Rating | Reasoning |
|---|---|---|
| Risk of bias | Serious | Contributing trials are sponsor-conducted and one is open-label. |
| Inconsistency | No concern | No serious concern identified in this domain. |
| Indirectness | No concern | No serious concern identified in this domain. |
| Imprecision | No concern | No serious concern identified in this domain. |
| Publication bias | Serious | Too few contributing studies for a formal assessment; the risk cannot be excluded. |
| Overall: Low certainty. Confidence in the effect estimate is limited. The true effect may be substantially different from the estimate. | ||
References cited on this page
References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.
- Lincoff AM, Brown-Frandsen K, Colhoun HM, Deanfield J, Emerson SS, Esbjerg S, Hardt-Lindberg S, Hovingh GK, Kahn SE, Kushner RF, Lingvay I, Oral TK, Michelsen MM, Plutzky J, Tornøe CW, Ryan DH. Semaglutide and cardiovascular outcomes in obesity without diabetes. New England Journal of Medicine 2023;389(24):2221–2232. doi:10.1056/NEJMoa2307563 · PMID 37952131
Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.
Compound Evidence Institute · CEI-ES-019/4 · https://compoundevidence.com/syntheses/surrogate-outcomes-in-obesity/summary-of-findings/ · retrieved 30 July 2026