Why plausible mechanism is not evidence of effect

Asking directly, because I could not find a straight answer: Why plausible mechanism is not evidence of effect

Session topic: STEP 2 (Lancet, 2021). Please read it before posting; the discussion is much better when everyone has.

The question I would like us to start with is what the trial set out to estimate, rather than what it found. Once that is on the table we can talk about whether the design could have answered it, and only then about the numbers.

Specific things I would like covered: the population and how far it generalises, how discontinuation was handled, whether the comparator was a fair one, and what the absolute rather than relative effect looks like.

I will summarise at the end and the summary will feed the relevant digest page.

Publication patterns in the BPC-157 literature: a large proportion of the evidence comes from one research group. That is not necessarily wrong — one group can do excellent work — but it is worth noting when evaluating the breadth of support for a claim.

TB-500 is usually the 7-residue actin-binding fragment of thymosin beta-4, not the full 43-residue protein. The two are routinely conflated in supplier documentation and in the literature. Evidence about the full protein does not automatically apply to the fragment.

This follows post #15 rather than contradicting it.

Oral versus injected administration claims for BPC-157: the preclinical work studied injection. Oral claims are common in supplier marketing and poorly supported by published evidence. If you are comparing orality between compounds, that is a distinction worth noting.