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I. The Title Page
II. Abstract: “Structured abstract” has become the standard for research papers (introduction, objective, methods, results and conclusions), while reviews, case reports and other articles have non-structured abstracts. The abstract should be a summary/synopsis of the paper.
III. Introduction: The “why did you do the study”; setting the scene or laying the foundation or background for the paper.
IV. Methods: The “how did you do the study.” Describe the --
V. Results: The “what did you find” --
VI. Discussion: Place for interpreting the results
VII. Conclusions: [occasionally optional or not required]. Do not reiterate the data or discussion. Can state hunches, inferences or speculations. Offer perspectives for future work.
VIII. Acknowledgements: Names people who contributed to the work, but did not contribute sufficiently to earn authorship. You must have permission from any individuals mentioned in the acknowledgements sections.
IX. References: Complete citations for any articles or other materials referenced in the text of the article.
A research report is a concise document that summarizes the findings, methods, and conclusions of a research study or investigation. There are various types of research reports available for different purposes.
It typically includes details on the research question, methodology, data analysis, and results, providing a structured and informative account of the research process and outcomes.
Limitations, key highlights.
1. technical or scientific reports.
Technical and scientific reports communicate research findings to experts and professionals in a particular field.
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Characteristics:
Popular reports are designed for a general audience and aim to inform, educate, or entertain on a wide range of topics.
Survey reports include data collected through surveys and focus on presenting insights and opinions on specific issues or questions.
Market research reports provide insights into consumer behavior, market trends, and industry analysis.
Case study reports focus on an in-depth examination of a single entity, often to explore complex, real-life situations.
Analytical research reports involve a deep analysis of data to uncover patterns, trends, or relationships.
Literature review reports provide an overview of existing research on a specific topic, highlighting gaps and trends.
Experimental research reports involve controlled experiments to test hypotheses and determine if the results support or reject the hypothesis.
Descriptive research reports aim to provide a comprehensive picture of a phenomenon, group, or situation. They seek to answer the “what” and “how” questions.
Exploratory research reports are conducted when there is little prior knowledge about a subject. They aim to identify key variables and research questions.
Explanatory research reports seek to understand the relationships between variables and explain why certain phenomena occur.
Policy or white papers aim to inform policymakers, stakeholders, and the public about specific issues and recommend actions.
These are some common components you must know while writing different types of research reports.
1. Title Page:
2. Abstract: Add a concise summary of the research, including the research question or objective, methodology, key findings, and implications. Typically, it should be no more than 150-250 words.
3. Table of Contents: Include a list of sections and subsections with page numbers.
4. List of Figures and Tables: If your research includes numerical data, add all the statistics and tables along with their corresponding page numbers. It is similar to a table of contents for quantitative data.
5. List of Abbreviations and Symbols: Include any abbreviations or symbols you have used in the report and their meanings.
6. Introduction:
7. Literature Review:
8. Methodology:
9. Results:
10. Discussion:
11. Conclusion:
12. References: Include a list of all the sources cited in your report in a standardized citation style (e.g., APA, MLA, Chicago).
Let us see an example of a research report.
Research Report: The Impact of Artificial Intelligence on the Labor Market
This research study explores the profound changes occurring in the labor market due to the increasing adoption of artificial intelligence (AI) technologies. The study examines the potential benefits and challenges AI poses for the workforce, job displacement, and the skills required in the future job market.
Introduction, literature review, methodology.
The introduction section provides an overview of the research topic. It explains the significance of studying the impact of AI on the labor market, outlines the research questions, and previews the structure of the report.
The literature review section reviews existing research on the effects of AI on employment and the labor market. It discusses the different perspectives on whether AI will create new jobs or lead to job displacement. It also explores the skills and education required for the future workforce.
This section explains the research methods used, such as data collection methods, sources, and analytical techniques. It outlines how data on AI adoption, job displacement, and future job projections were gathered and analyzed.
The results section presents the key findings of the study. It includes data on the extent of AI adoption across industries, job displacement rates, and projections for AI-related occupations.
The discussion section interprets the results in the context of the research questions. It analyzes the potential benefits and challenges AI poses for the labor market, discusses policy implications, and explores the role of education and training in preparing the workforce for the AI era.
In conclusion, this research highlights the transformative impact of artificial intelligence on the labor market. While AI brings opportunities for innovation and efficiency, it also presents challenges related to job displacement and workforce adaptation. Preparing for this evolving job landscape is crucial for individuals and policymakers.
Given below are various types of research reports writing that researchers and organizations use to present findings, progress, and other information.
Outlines a plan for a project or research for approval or funding. | Research proposal submitted to study the impact of climate change on local ecosystems. | |
Generated at regular intervals to provide project updates. | Weekly sales reports summarizing product sales figures. | |
Detailed, structured reports often used in academic, scientific, or business settings. | Formal business report analyzing a company’s financial performance for the year. | |
Less structured reports for quick internal communication. | Email summarizing key takeaways from a team meeting. | |
Concise documents offering a brief overview of a specific topic. | A one-page summary of customer feedback from a product launch. | |
Comprehensive reports with in-depth analysis and information. | 100-page research report on the effects of a new drug on a medical condition. | |
Focus on data analysis and provide insights or recommendations. | Market research report analyzing consumer behavior trends and recommending marketing strategies. | |
Convey information without providing analysis or recommendations. | Report detailing the steps of a manufacturing process for new employees. | |
Flow within the organizational hierarchy, moving up or down. | Report from a department manager to the company’s vice president on department performance. | |
Sent between individuals or departments at the same organizational level. | Report from one project manager to another project manager in a different department. | |
Created and distributed within an organization for internal purposes. | Internal audit report examining the company’s financial records for compliance. | |
Prepared for external audiences, such as clients, investors, or regulators. | A publicly traded company publishes an annual report for shareholders and the general public. |
Here is why the different types of research reports are important.
Listed below are some limitations of different types of research reports.
Different types of research reports are important for sharing knowledge, making smart choices, and moving forward in different areas of study. It’s vital for both researchers and those who use research to grasp the different kinds of reports, what goes into them, and why they matter.
Q1. Are research reports the same as research papers? Answer: Research reports and research papers share similarities but have distinct purposes and structures. Research papers are often more academic and can vary in structure, while research reports are typically more structured and cater to a broader audience.
Q2. How do I choose the right type of research report for my study? Answer: The choice of research report type depends on your research goals, audience, and the nature of your study. Consider whether you are conducting scientific research, market analysis, academic research, or policy analysis, and select the format that aligns with your objectives.
Q3. Can research reports be used as references in other research reports? Answer: Yes, research reports can be cited and used as references in other research reports as long as they are credible sources. Citing previous research reports adds depth and credibility to your work.
This article lists all the types of research reports available for research methodologies. We have also included its format, example, and several report-writing methods. For similar articles, you can check the following articles,
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BMI indicates body mass index; CKD, chronic kidney disease; ESKD, end-stage kidney disease; GLP-1 RA, glucagon-like peptide 1 receptor agonist; ICH, intracranial hemorrhage; MI, myocardial infarction; SBP, systolic blood pressure.
AHR indicates adjusted hazard ratio; AKI, acute kidney injury; GLP-1 RA, glucagon-like peptide 1 receptor agonist; MACE, major adverse cardiovascular event; MAKE, major adverse kidney event.
GLP-1 RA indicates glucagon-like peptide 1 receptor agonist.
eTable 1. Demographic, Diagnostic, Procedural, Medication, Visit, and Laboratory Codes Used in the Definition of the Cohorts
eTable 2. Demographic, Diagnostic, and Laboratory Codes Used in the Definition of Covariates
eTable 3. Diagnostic, Visit, and Procedural Codes Used in the Definition of Outcomes
eTable 4. Numbers and Characteristics of Individuals Excluded Because of a Lack of Any Follow-Up
eTable 5. Adjusted Hazard Ratios for the Components of Major Adverse Cardiovascular Events and Kidney Events
eTable 6. Sensitivity Analysis Incorporating Individuals Without Follow-Up Into Propensity Score Matching and Survival Analysis of Primary and Secondary Outcomes
eTable 7. Changes in Mean Glycated Hemoglobin Level and Body Weight (95% CI)
eFigure 1. Changes in Glycated Hemoglobin Level and Body Weight From Baseline
eFigure 2. Forest Plot of Primary and Secondary Outcomes Compared Between Different Doses of Tirzepatide and GLP-1 RA
eFigure 3. Results for Negative Control Outcomes and Analysis With Negative Control Exposure
eFigure 4. Subgroup Analysis of All-Cause Mortality Between Tirzepatide and GLP-1 RA Groups
eFigure 5. Subgroup Analysis of Major Adverse Cardiovascular Events Between Tirzepatide and GLP-1 RA Groups
eFigure 6. Subgroup Analysis of the Composite of Major Adverse Cardiovascular Events and All-Cause Mortality Between Tirzepatide and GLP-1 RA Groups
eFigure 7. Subgroup Analysis of Kidney Events Between Tirzepatide and GLP-1 RA Groups
eFigure 8. Subgroup Analysis of Acute Kidney Injury Between Tirzepatide and GLP-1 RA Groups
eFigure 9. Subgroup Analysis of Major Adverse Kidney Events Between Tirzepatide and GLP-1 RA Groups
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Chuang M , Chen J , Wang H , Jiang Z , Wu V. Clinical Outcomes of Tirzepatide or GLP-1 Receptor Agonists in Individuals With Type 2 Diabetes. JAMA Netw Open. 2024;7(8):e2427258. doi:10.1001/jamanetworkopen.2024.27258
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Question What is the association of tirzepatide vs glucagon-like peptide 1 receptor agonist (GLP-1 RA) treatment with all-cause mortality and adverse cardiovascular or kidney events in US patients with type 2 diabetes?
Findings In this cohort study of 140 308 patients with type 2 diabetes, treatment with tirzepatide was associated with significantly lower hazards of all-cause mortality and major adverse cardiovascular and kidney events compared with GLP-1 RA.
Meaning These findings suggest that treatment with tirzepatide may confer additional clinical benefits for patients with type 2 diabetes.
Importance Despite its demonstrated benefits in improving cardiovascular risk profiles, the association of tirzepatide with mortality and cardiovascular and kidney outcomes compared with glucagon-like peptide 1 receptor agonists (GLP-1 RAs) remains unknown.
Objective To investigate the association of tirzepatide with mortality and adverse cardiovascular and kidney outcomes compared with GLP-1 RAs in patients with type 2 diabetes.
Design, Setting, and Participants This retrospective cohort study used US Collaborative Network of TriNetX data collected on individuals with type 2 diabetes aged 18 years or older initiating tirzepatide or GLP-1 RA between June 1, 2022, and June 30, 2023; without stage 5 chronic kidney disease or kidney failure at baseline; and without myocardial infarction or ischemic or hemorrhagic stroke within 60 days of drug initiation.
Exposures Treatment with tirzepatide compared with GLP-1 RA.
Main Outcomes and Measures The primary outcome was all-cause mortality, and secondary outcomes included major adverse cardiovascular events (MACEs), the composite of MACEs and all-cause mortality, kidney events, acute kidney injury, and major adverse kidney events. All outcomes were analyzed using Cox proportional hazards regression models.
Results There were 14 834 patients treated with tirzepatide (mean [SD] age, 55.4 [11.8] years; 8444 [56.9%] female) and 125 474 treated with GLP-1 RA (mean [SD] age, 58.1 [13.3] years; 67 474 [53.8%] female). After a median (IQR) follow-up of 10.5 (5.2-15.7) months, 95 patients (0.6%) in the tirzepatide group and 166 (1.1%) in the GLP-1 RA group died. Tirzepatide treatment was associated with lower hazards of all-cause mortality (adjusted hazard ratio [AHR], 0.58; 95% CI, 0.45-0.75), MACEs (AHR, 0.80; 95% CI, 0.71-0.91), the composite of MACEs and all-cause mortality (AHR, 0.76; 95% CI, 0.68-0.84), kidney events (AHR, 0.52; 95% CI, 0.37-0.73), acute kidney injury (AHR, 0.78; 95% CI, 0.70-0.88), and major adverse kidney events (AHR, 0.54; 95% CI, 0.44-0.67). Treatment with tirzepatide was associated with greater decreases in glycated hemoglobin (treatment difference, −0.34 percentage points; 95% CI, −0.44 to −0.24 percentage points) and body weight (treatment difference, −2.9 kg, 95% CI, −4.8 to −1.1 kg) compared with GLP-1 RA. An interaction test for subgroup analysis revealed consistent results stratified by estimated glomerular filtration rate, glycated hemoglobin level, body mass index, comedications, and comorbidities.
Conclusions and Relevance In this study, treatment with tirzepatide was associated with lower hazards of all-cause mortality, adverse cardiovascular events, acute kidney injury, and adverse kidney events compared with GLP-1 RA in patients with type 2 diabetes. These findings support the integration of tirzepatide into therapeutic strategies for this population.
Cardiovascular and kidney diseases are prevalent in patients with diabetes, causing substantial morbidity and mortality. 1 - 3 Many hypoglycemic agents have been evaluated for cardiovascular and kidney protection beyond their originally designed hypoglycemic effects. 4 Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) were found to improve kidney and cardiovascular outcomes, 5 , 6 with new trials ongoing and results emerging.
Tirzepatide, a dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) RA, was developed in view of the synergistic effect of both receptors in achieving negative energy balance besides facilitating glucose-dependent insulin secretion. 7 Studies have shown tirzepatide’s superiority over semaglutide in reducing glycated hemoglobin (HbA 1c ) and weight (additional reductions of 0.15-0.45 percentage points in HbA 1c and 1.9-5.5 kg in body weight) in patients with type 2 diabetes. 8 Compared with insulin glargine, tirzepatide has been shown to ameliorate annual estimated glomerular filtration rate (eGFR) decline by 2.2 mL/min/1.73 m 2 and to reduce the urine albumin-to-creatinine ratio by 31.9%. 9 , 10 Favorable effects on additional cardiovascular risk factors, including atherogenic lipoproteins and blood pressure, were also observed with tirzepatide compared with semaglutide (increase of 6.8%-7.9% vs 4.4% in high-density lipoprotein cholesterol, decrease of 17.5%-23.7% vs 11.1% in very-low-density lipoprotein cholesterol, and decrease of 4.8-6.5 mm Hg vs 3.6 mm Hg in systolic blood pressure). 8 However, whether these metabolic improvements lead to benefits in survival and kidney or cardiovascular outcomes remains unclear.
One meta-analysis of randomized clinical trials (RCTs) reported noninferiority of tirzepatide for cardiovascular safety compared with the control groups, 11 though the included studies were highly heterogenous regarding their comparators (ie, placebo, insulin, GLP-1 RA) and trial participant characteristics, thus precluding a solid conclusion. 11 Notably, there is a lack of studies directly comparing tirzepatide with GLP-1 RAs, thereby necessitating further investigation in this context. Hence, we investigated the association of tirzepatide with mortality and adverse cardiovascular and kidney outcomes compared with GLP-1 RAs in US patients with type 2 diabetes.
This cohort study used data from the TriNetX database, which collects deidentified, patient-level data from electronic health records. Information in the TriNetX database comes from health care organizations (HCOs), typically academic health care centers, that collect data from their main and satellite hospitals and outpatient clinics. Available data include demographics, diagnoses (based on International Classification of Diseases, Tenth Revision, Clinical Modification codes), procedures (classified by International Classification of Diseases, Tenth Revision Procedure Coding System or Current Procedural Terminology ), medications (Veterans Affairs Drug Classification System and RxNorm codes), laboratory tests (organized using Logical Observation Identifiers Names and Codes), and health care utilization records. We used the US Collaborative Network in TriNetX, which includes data from more than 100 million patients from 62 HCOs in the US.
Patient-level data were analyzed using the built-in statistical tool on the TriNetX platform, which is based on Java, version 11.0.16 (Oracle); R, version 4.0.2 (with packages Hmisc, version 4.1-1 and Survival, version 3.2-3) (R Project for Statistical Computing); and Python, version 3.7 (with the libraries lifelines, version 0.22.4; matplotlib, version 3.5.1; numpy, version 1.21.5; pandas, version 1.3.5; scipy, version 1.7.3; and statsmodels, version, 0.13.2) (Python Software Foundation), with the outputs validated using independent, industry-standard methods. The results were provided to investigators in summarized format. Details regarding the database can be found online 12 and as previously described. 13 , 14
Ethical approval for using the TriNetX database in this study was granted by Chi Mei Hospital’s institutional review board, and institutional review boards from all hospitals involved. Informed consent was waived because this study was conducted using only aggregated statistical summaries of deidentified information. This study was conducted adhering to the principles of the Declaration of Helsinki 15 and adhered to the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline.
Patients aged 18 years or older with type 2 diabetes and prescribed tirzepatide or a GLP-1 RA during June 1, 2022, through June 30, 2023, were included because tirzepatide was approved by the US Food and Drug Administration on May 13, 2022. Individuals with acute myocardial infarction, intracranial hemorrhage, or cerebral infarction within 60 days before the index prescription date were excluded to avoid misidentifying incident outcomes. The patients were divided into tirzepatide and GLP-1 RA groups, excluding those previously given medications from the counterpart groups (ie, GLP-1 RA for the tirzepatide group and tirzepatide for the GLP-1 RA group) within 6 months before or any time after the index prescription. To achieve an incident user design, patients with prior use of a GLP-1 RA or tirzepatide before the index date were excluded. To mitigate misinterpretation, individuals with stage 5 chronic kidney disease (CKD), with end-stage kidney disease (ESKD), or receiving dialysis at baseline were excluded from the major adverse kidney event (MAKE) outcome analysis.
We conducted 1:1 propensity score matching (PSM) that involved 48 variables covering demographics, comorbidities, medications, and laboratory results. Patients in both groups were followed for a maximum of 21 months or until data analysis on May 2, 2024. Details regarding the codes used to identify the demographics, diagnoses, procedures, medications, and laboratory results are provided in eTable 1 in Supplement 1 .
Covariate selection was guided by clinical relevance, encompassing major comorbidities and risk factors that could contribute to mortality, cardiovascular or kidney outcomes, and baseline health status in accordance with current knowledge. We considered the following variables to adjust for imbalances in baseline characteristics between the tirzepatide and GLP-1 RA groups: age; sex; race and ethnicity (as documented in the electronic health record); cardiovascular disease; dementia; chronic lower-respiratory disease; autoimmune disease; CKD; chronic hepatitis; liver cirrhosis; anemia; HIV; neoplasms; socioeconomic status and psychosocial-related health hazards; diabetic complications; and medicines including diuretics, lipid-lowering agents, hypoglycemic agents, and hypotensive agents. We further adjusted for body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared), systolic blood pressure, hemoglobin, total cholesterol, low-density lipoprotein (LDL) cholesterol, HbA 1c , and eGFR. Additional details on the categorization and codes adopted to define the covariates are provided in Table 1 and eTable 2 in Supplement 1 .
The primary outcome was all-cause mortality during the follow-up period. Secondary outcomes included major adverse cardiovascular events (MACEs), including myocardial infarction, ischemic or hemorrhagic stroke, or cardiac death; kidney events, including stage 5 CKD, ESKD, or need for dialysis; and MAKEs, including stage 5 CKD, ESKD, need for dialysis, or death.
Additionally, we investigated acute kidney injury (AKI) and the composite of all-cause mortality and MACEs. To establish a baseline for comparison, we included hernia, traumatic intracranial injury, sensorineural hearing loss, skin cancer, and lumbar radiculopathy as negative control outcomes, with selective serotonin reuptake inhibitors and simethicone as negative control exposures. Each component of the composite outcomes was also evaluated for consistency of effect direction. Changes in HbA 1c and body weight were evaluated at 4, 8, 12, 16, and 20 months after the index date. The diagnostic, visit, and procedural codes used to define these outcomes are provided in eTable 3 in Supplement 1 .
We performed prespecified subgroup analyses based on baseline eGFR (≥45 or <45 mL/min/1.73 m 2 ); HbA 1c (≥7% or <7%); BMI (≥30 or <30); presence of hypertension, ischemic heart disease, heart failure, or proteinuria; use of metformin, insulin, sodium-glucose cotransporter 2 inhibitors (SGLT2is), angiotensin-converting enzyme inhibitors (ACEis), or angiotensin II receptor blockers (ARBs); or previous GLP-1 RA use in the tirzepatide group. To investigate potential differences based on drug indications, such as glycemic control or weight reduction, we also stratified the patients by HbA 1c level and BMI as follows: normal BMI of less than 25 (may have received the medications for diabetes control), BMI of 25 or higher and HbA 1c less than 7% (may have been treated for weight loss given that their HbA 1c was below the target per current treatment guidelines 16 ), and BMI of 25 or higher and HbA 1c greater than 7% (may have been treated for both weight loss and glycemic control).
The potential dose effect was evaluated by comparing different tirzepatide doses (maximum ≤7.5 mg or ≥10 mg) with the maximal doses of GLP-1 RA. To investigate the robustness of our findings, a sensitivity analysis was conducted by incorporating individuals without follow-up outcomes into PSM and survival analysis.
Baseline characteristics of the tirzepatide and GLP-1 RA groups were presented as means with SDs or counts with percentages. Categorical variables were compared by χ 2 test and continuous variables by independent 2-sample t test. One-to-one PSM was performed using the greedy nearest neighbor algorithm with a caliper of 0.1 pooled SDs to balance baseline characteristics between the 2 groups. Variables were considered adequately matched if the between-group standardized difference was less than 0.1. The Kaplan-Meier method was used to calculate survival probabilities after PSM. Adjusted hazard ratios (AHRs) with 95% CIs and P values were calculated using Cox proportional hazards regression models for all outcomes. The quantitative effect of unmeasured confounding was analyzed using the E-value method, which assesses the effect magnitude required for unaccounted confounders to elucidate the observed variances between the 2 groups. An E-value of x indicates that the observed association could be explained away only by an unmeasured confounder associated with both the treatment and the outcome by a risk ratio of at least x -fold each, beyond the measured confounders. 17 Proportional hazard assumption was tested using Schoenfeld residuals. Missing data regarding the outcomes were addressed by excluding the respective cases. Likewise, patients lost to follow-up were excluded to avoid bias or inaccuracies from incomplete data. All tests were 2-sided with P < .05. For the 6 primary and secondary outcomes, Bonferroni correction was applied to account for multiple comparisons, with α set at .0083, providing an overall type I error rate of .0488. Statistical analyses were conducted using the analytic tool on the TriNetX platform and R, version 4.2.2.
Within the cohort of patients with type 2 diabetes, 14 834 received tirzepatide, while 125 474 were prescribed a GLP-1 RA during the study time frame ( Figure 1 ). The numbers of patients excluded due to lack of follow-up after the index date were 348 of 15 182 (2.3%) prescribed tirzepatide and 4141 of 129 615 (3.2%) prescribed a GLP-1 RA. The characteristics of patients lost to follow-up were similar between groups, including younger age, a high proportion of male and Black individuals, high HbA 1c , and few comorbidities (eTable 4 in Supplement 1 ). Following PSM, each group included 14 832 individuals for our outcome analyses ( Table 1 ).
Before PSM, tirzepatide-treated patients were younger (mean [SD] age, 55.4 [11.8] years) compared with the GLP-1 RA group (mean [SD] age, 58.1 [13.3] years) ( P < .001). Additionally, the tirzepatide group had a higher percentage of White patients (67.3% vs 60.4%; P < .001), whereas the GLP-1 RA group had higher percentages of Black (20.1% vs 17.0%), Asian (3.6% vs 2.3%), and Hispanic or Latinx (9.3% vs 6.5%) patients; and a higher percentage of female patients (56.9% vs 53.8%; P < .001), whereas the GLP-1 RA group a higher percentage of males (42.5% vs 37.5%). Patients in the tirzepatide group also had lower prevalence rates of CKD or anemia, and fewer were using statins, biguanides, sulfonylureas, dipeptidyl peptidase 4 inhibitors, β-blockers, ARBs, or calcium channel blockers. After PSM, the 2 groups were balanced, with standardized differences for all the included covariates being less than 0.1 ( Table 1 ).
The overall cohort was followed up for a median of 10.5 months (IQR, 5.2-15.7 months). During the follow-up period, 95 patients (0.6%) in the tirzepatide group and 166 (1.1%) in the GLP-1 RA group died. We observed a lower hazard of all-cause mortality in patients given tirzepatide compared with GLP-1 RA (AHR, 0.58; 95% CI, 0.45-0.75; P < .001) ( Table 2 ; Figure 2 ; Figure 3 ). The test for proportionality showed no violation of the proportional hazards assumption (Schoenfeld test P = .94).
The hazard of MACEs was lower among patients treated with tirzepatide (AHR, 0.80; 95% CI, 0.71-0.91; P < .001), as was the hazard of kidney events (AHR, 0.52; 95% CI, 0.37-0.73; P < .001), AKI (AHR, 0.78; 95% CI, 0.70-0.88; P < .001), MAKEs (AHR, 0.54; 95% CI, 0.44-0.67; P < .001), and the composite of MACEs and all-cause mortality (AHR, 0.76; 95% CI, 0.68-0.84; P < .001), favoring tirzepatide ( Table 2 ; Figure 2 ). Our E-value analysis indicated an unlikely significant influence from unmeasured confounders (E-values of the point estimates [upper limits of the CI] for all-cause mortality, MACEs, and kidney events were 2.82 [1.99], 1.79 [1.44], and 3.24 [2.09], respectively) ( Table 2 ). The hazard of each MACE component (ie, myocardial infarction, ischemic or hemorrhagic stroke, cardiac death) and MAKE component (ie, stage 5 CKD or ESKD) was consistently lower with tirzepatide compared with GLP-1 RAs, with AHRs ranging from 0.78 (95% CI, 0.67-0.91) to 0.91 (95% CI, 0.56-1.45) for MACE components and from 0.45 (95% CI, 0.25-0.82) to 0.49 (95% CI, 0.35-0.67) for MAKE components (eTable 5 in Supplement 1 ). Sensitivity analysis incorporating patients without any follow-up into PSM and survival analyses showed consistent results with our main analysis (eTable 6 in Supplement 1 ).
Compared with GLP-1 RA treatment, tirzepatide treatment was associated with greater reductions in HbA 1c (treatment difference, −0.34 percentage points; 95% CI, −0.44 to −0.24 percentage points) and body weight (treatment difference, −2.9 kg; 95% CI, −4.8 to −1.1 kg) over 20 months. The most significant HbA 1c decrease occurred within the first 4 months and stabilized after 8 months, while weight reduction persisted through 16 to 20 months (eTable 7 and eFigure 1 in Supplement 1 ).
Results comparing tirzepatide vs maximal doses of GLP-1 RA closely matched the main analysis, with similar AHRs and corresponding 95% CIs (eFigure 2A in Supplement 1 ). When stratified by tirzepatide dose, treatment with 10 mg or more was associated with lower hazards of all-cause mortality, MACEs, and MAKEs compared with 7.5 mg or less (eFigure 2B and C in Supplement 1 ).
Our study revealed no significant differences in the hazard of negative control outcomes between the tirzepatide and GLP-1 RA groups for hernia, traumatic intracranial injury, sensorineural hearing loss, lumbar radiculopathy, and skin cancer. Results were consistent when selective serotonin reuptake inhibitors and simethicone were introduced as negative control exposures (eFigure 3 in Supplement 1 ). The interaction test revealed no significant effect differences across all subgroups stratified by eGFR; HbA 1c ; presence of hypertension, ischemic heart disease, heart failure, proteinuria, or diabetic complications; use of metformin, insulin, SGLT2is, ACEis, or ARBs; previous use of GLP-1 RAs; potential treatment indications (body weight loss, glycemic control, or both); LDL cholesterol level; or BMI (all interaction test P > .05) (eFigures 4-9 in Supplement 1 ).
From this retrospective cohort study of 140 308 US patients with type 2 diabetes treated with tirzepatide or GLP-1 RAs, we have for the first time to our knowledge presented evidence substantiating that tirzepatide therapy is associated with lower risks of all-cause mortality, MACEs, MAKEs, and AKI compared with GLP-1 RA therapy after a median follow-up of 10.5 months. Consistent results were found in subgroup analyses stratified by eGFR; HbA 1c ; presence of cardiovascular disease, proteinuria, or diabetic complications; use of metformin, insulin, SGLT2is, ACEis, or ARBs; previous GLP-1 RA treatment; potential indications; LDL cholesterol level; and BMI.
The association of tirzepatide with less all-cause mortality and MACEs may be attributable to tirzepatide’s efficacy in improving the cardiovascular risk profile, including blood pressure, LDL, triglycerides, HbA 1c , 8 , 18 cardiovascular risk biomarkers, 19 and body weight in patients with obesity. 18 , 20 Consistently, a network meta-analysis comparing various GLP-1 RAs and dual and triple receptor agonists showed that tirzepatide was the most effective in reducing HbA 1c , fasting glucose, triglyceride level, and waist circumference compared with all other GLP-1 RAs. 21 The meta-analysis also ranked tirzepatide second for weight loss, surpassed only by cagrilintide-semaglutide, another dual receptor agonist under development. Our analysis similarly showed an association of greater HbA 1c and weight loss with tirzepatide, and the trajectories aligned with those reported in previous trials, 8 suggesting a potential mediatory role for these factors. This finding is in line with a recent report in which withdrawing tirzepatide led to substantial weight regain. 22 Nonetheless, studies on the efficacy of tirzepatide in reducing adverse cardiovascular outcomes have yielded inconsistent results, suggesting that GIP may have both beneficial 23 , 24 and untoward cardiovascular effects, 25 , 26 though the results may be due to reverse causality.
While 1 meta-analysis of 7 RCTs reported no significant difference in all-cause mortality, cardiovascular mortality, and MACE risk between tirzepatide and a mix of comparators, including placebo, 2 insulin formulations, and GLP-1 RAs, 11 another study of 8 RCTs contrarily showed a significant decrease in all-cause mortality and MACE risk with tirzepatide treatment compared with the control group receiving placebo or active comparators. 27 The disparity may be due to differences in the included studies, comparators, sample sizes, baseline patient characteristics, and outcome definitions. Both studies carried high clinical heterogeneity in participant inclusion criteria and comparator selection. Of note, previous trials on tirzepatide and GLP-1 RAs for cardiovascular and mortality outcomes had median follow-ups of 1.6 to 3.8 years, 28 , 29 but the survival curves for composite primary cardiovascular outcomes began diverging as early as 8 weeks to approximately 6 months, 28 - 31 suggesting potential early benefits after treatment initiation.
Both GLP-1 and GIP belong to the incretin system that regulates hormone secretion in response to carbohydrate intake. 32 Although the effect of GIP has been found to be greatly attenuated in patients with type 2 diabetes, 33 subsequent research has shown that islet β-cell sensitivity to GIP may be restored with glycemic control. 34 Glucose-dependent insulinotropic polypeptide acts in the central nervous system by blocking nausea and emesis from GLP-1 agonism without affecting satiety or energy intake reduction, 35 thereby improving overall treatment tolerability. In animal studies, dual GLP-1 and GIP coagonists synergistically reduced fat mass and improved metabolic profiles superior to selective GLP-1 agonist, contrary to selective GIP agonist, which was weight neutral. 36 Subsequent clinical trials confirmed that tirzepatide was more effective than selective GLP-1 agonists in increasing insulin secretion and sensitivity, improving meal tolerance, and suppressing glucagon secretion, 37 with similar suppression of appetite and calorie intake. 38 Additionally, nutrition-independent regulation of the GIP pathway through inflammatory stimuli may stabilize atherosclerosis plaques by inhibiting monocyte and macrophage activation 39 and suppressing cardiomyocyte enlargement, apoptosis, and interstitial fibrosis. 40 The potential superiority of GIP and GLP-1 RAs over GLP-1 RAs for MACEs and mortality, as suggested by our findings, indicates that combined activation of GIP and GLP-1 receptors may provide additional benefits over the activation of GLP-1 receptors alone.
The kidney-protective effect of tirzepatide was first shown in post hoc analyses of the SURPASS-4 (Tirzepatide vs Insulin Glargine in Type 2 Diabetes and Increased Cardiovascular Risk) trial, which recruited patients with type 2 diabetes, overweight, and established or high risk for cardiovascular disease. Patients treated with tirzepatide added to insulin had less eGFR decline 10 , 41 and proteinuria progression and fewer composite kidney end points compared with the insulin group. 10 These findings align with studies on selective GLP-1 agonists. 42 Notably, our study is the first, to our knowledge, to directly compare the association with kidney outcomes between tirzepatide and selective GLP-1 RAs. Preclinical studies suggested that GIP may attenuate local adipose tissue inflammation and reduce proinflammatory cytokine levels, 43 which may act favorably on the pathogenesis of diabetic kidney disease. 44 On the other hand, GLP-1 receptors are present on preglomerular vascular smooth muscle, glomerular, and tubular cells and, thus, may directly affect the kidney. 45 , 46 Proposed mechanisms include afferent arteriole vasodilation, proximal tubular diuresis, and inhibition of glomerular hyperfiltration. 45 , 47 Importantly, pharmacokinetic studies showed that tirzepatide exposure was not significantly affected by kidney function impairment 48 and represented a viable therapy for patients with stage 4 and 5 CKD, for whom few options existed. 49 Treatment with tirzepatide or a GLP-1 RA might pose a risk of AKI due to dehydration from gastrointestinal adverse effects. 50 , 51 Although our analysis found a lower hazard of AKI in the tirzepatide group compared with the GLP-1 RA group, this result should be interpreted with caution since we could not identify the cause of these AKI events or their chronologic association with tirzepatide or GLP-1 RA use.
The interaction test from subgroup analyses revealed no significant discrepancies in our primary and secondary outcomes among different subgroups. Of note, most patients included in this study were relatively healthy, with an eGFR of at least 45 mL/min/1.73 m 2 ; no history of ischemic heart disease or heart failure; and not taking metformin, insulin, SGLT2is, ACEis, or ARBs. Accordingly, the null results from our subgroup analyses may be partly due to reduced statistical power from smaller sample sizes. Nevertheless, for individuals already benefiting from efficacious treatments, the integration of GIP agonists surpassed the efficacy of existing therapeutic regimens in specific combinations. The potential dose-response relationships observed in our analysis stratified by tirzepatide dose also support tirzepatide’s possible efficacy.
Our findings also provide directions for future research in other target populations. The observational nature of our data precluded inference of causality, which might be confirmed in future research, such as in ongoing RCTs evaluating the efficacy of tirzepatide in improving cardiovascular and kidney outcomes compared with GLP-1 agonists 52 and in treating patients with heart failure with preserved ejection fraction. 53
This study has some limitations. First, data from TriNetX were registry based, and therefore, misidentification and underrepresentation of mild cases or of individuals not engaged with the health care system may exist and influence the results. The reliance on diagnostic codes to identify variables and outcomes may also result in misclassification, potentially biasing the results. To address this information bias, we conducted specificity tests comparing unrelated events between the tirzepatide and GLP-1 RA groups and found no significant differences, indicating little registration bias. Second, the duration of treatment could not be ascertained from the database, precluding analysis of a long-term carryover effect. While we observed clinical benefits, their effect sizes were relatively imprecise when interpreting the confidence intervals and require further investigation. Third, unmeasured variables may have contributed to the studied outcomes, introducing additional confounding. Given the observational nature of this study and that some baseline characteristics differed between the groups, residual confounding cannot be eliminated entirely. To address potential bias, we juxtaposed unrelated events among GLP-1 RA and tirzepatide users, finding no discernible disparities and indicating that bias from residual confounding may be negligible. We also used comedication and biochemical results as proxies for disease severity to mitigate potential confounding. Higher E-values that surpassed the hazard ratios indicated that minor unaccounted confounders could not counteract the observed association, thus increasing the potential for causality. Fourth, although consistent results were found in sensitivity analyses incorporating individuals lost to follow-up into survival analysis, much of the nonsummarized data and their changes over time were restricted from investigators to safeguard the detailed health information from potential misuse in identifying and tracking specific individuals, thereby precluding further imputation methods. Fifth, information directly related to socioeconomic status, including education, income, and insurance status, was not documented, limiting further investigation into their contributions. Finally, this study comprised patients with type 2 diabetes, of whom most were relatively healthy without underlying cardiovascular or advanced kidney diseases, so the applicability of our findings to other clinical settings remain to be explored.
In summary, this cohort study provided evidence supporting the association of tirzepatide treatment, compared to GLP-1 RAs, with lower hazards of all-cause mortality and adverse cardiovascular or kidney events through a head-to-head comparison in patients with type 2 diabetes. These insights advocate for the integration of tirzepatide into therapeutic strategies for managing type 2 diabetes and highlight its potential to enhance current clinical practice.
Accepted for Publication: June 13, 2024.
Published: August 12, 2024. doi:10.1001/jamanetworkopen.2024.27258
Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2024 Chuang MH et al. JAMA Network Open .
Corresponding Author: Vin-Cent Wu, MD, PhD, National Taiwan University Hospital, 7 Chung-Shan South Rd, Zhong-Zheng District, Taipei 100, Taiwan ( [email protected] ).
Author Contributions: Drs Chuang and Wu had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Chuang, Wang, Wu.
Acquisition, analysis, or interpretation of data: Chuang, Chen, Jiang.
Drafting of the manuscript: Chuang, Chen, Jiang.
Critical review of the manuscript for important intellectual content: Chuang, Wang, Wu.
Statistical analysis: Chuang, Jiang.
Administrative, technical, or material support: Chen, Jiang.
Supervision: Wang, Wu.
Conflict of Interest Disclosures: None reported.
Data Sharing Statement: See Supplement 2 .
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us components. Besides this, the significance of aresearch report and different t. tanding about the format of a research article, anabst. act, a thesis and dissertation. es for research journals and to prepare a compl. report after conducting a research worwproject.
In a research report th ese components are arranged succ essively in the body. sections consisting of introduction, literature review, method, results, discussion, and. conclusion. In addition t o ...
Abstract. This guide for writers of research reports consists of practical suggestions for writing a report that is clear, concise, readable, and understandable. It includes suggestions for terminology and notation and for writing each section of the report—introduction, method, results, and discussion. Much of the guide consists of ...
Use the section headings (outlined above) to assist with your rough plan. Write a thesis statement that clarifies the overall purpose of your report. Jot down anything you already know about the topic in the relevant sections. 3 Do the Research. Steps 1 and 2 will guide your research for this report.
Thesis. Thesis is a type of research report. A thesis is a long-form research document that presents the findings and conclusions of an original research study conducted by a student as part of a graduate or postgraduate program. It is typically written by a student pursuing a higher degree, such as a Master's or Doctoral degree, although it ...
Idea 1: The problem to be investigated. This should be 1-2 sentences that sum up why this study was conducted. For example: "Several studies have suggested that rampart craters on Mars form in regions with high soil volatile contents - namely, water ice.". Idea 2: The purpose of the study.
Paper www.communicate.gse.harvard.edu Academic papers are like hourglasses. The paper opens at its widest point; the introduction makes broad connections to the reader's interests, hoping they will be persuaded to follow along, then gradually narrows to a tight, focused, thesis statement.
What are the implications of the findings? The research report contains four main areas: Introduction - What is the issue? What is known? What is not known? What are you trying to find out? This sections ends with the purpose and specific aims of the study. Methods - The recipe for the study. If someone wanted to perform the same study ...
address of the author/ s and the date. The report's title should be no longer than 12- 15 words and in a larger font size (e.g. 16-20 point) than the rest of the text on the cover page. Make ...
There are three main forms of reports: factual, instructional and persuasive; each has a different purpose and will require different arguments and evidence to achieve that purpose. It will help you write good reports if you know what you are trying to achieve before you start your report. Factual. Instructional. Persuasive.
A research report is a well-crafted document that outlines the processes, data, and findings of a systematic investigation. It is an important document that serves as a first-hand account of the research process, and it is typically considered an objective and accurate source of information.
Writing a report involves the following stages -. · clarifying terms of reference, · planning the work, · collecting data and information, · organising and structuring the collected information, · writing the first draft, and. · final proof-checking and re-drafting of report.
.pdf version of this page. This review covers the basic elements of a research report. This is a general guide for what you will see in journal articles or dissertations. This format assumes a mixed methods study, but you can leave out either quantitative or qualitative sections if you only used a single methodology.
The research reports of students of M.Sc., M.Ed., MA(DE), M.Phil. or Doctoral programmes take the form of a thesis or dissertation. In the following sections we shall discuss the main components of a research report. The entire research report is mainly divided into three major divisions — the beginning, the main body and the end (please see ...
Simply, a research paper/report is a systematic write up. on the findings of the study including methodologies, discussion, conclusions etc. following a definite. style. T he resea rch report ...
eGyanKosh preserves and enables easy and open access to all types of digital content including text, images, moving images, mpegs and data sets ... Unit-22 Research Report: Various Components and Structure: Issue Date: 20-Apr-2017: ... Description Size Format ; Unit-22.pdf: 1.01 MB: Adobe PDF: View/Open: Show full item record Items in eGyanKosh ...
An outline of the research questions and hypotheses; the assumptions or propositions that your research will test. Literature Review. Not all research reports have a separate literature review section. In shorter research reports, the review is usually part of the Introduction. A literature review is a critical survey of recent relevant ...
Abstract: "Structured abstract" has become the standard for research papers (introduction, objective, methods, results and conclusions), while reviews, case reports and other articles have non-structured abstracts. The abstract should be a summary/synopsis of the paper. III. Introduction: The "why did you do the study"; setting the ...
Comprehensive reports with in-depth analysis and information. 100-page research report on the effects of a new drug on a medical condition. Analytical. Focus on data analysis and provide insights or recommendations. Market research report analyzing consumer behavior trends and recommending marketing strategies.
ntial Components11. Goals. Why is your study worth doing? Why do you want to co. ct. this study, and why s. ould we care about the results? 2. Conceptual Framework. What do you think is going. on with the issues, settings, or people you plan to study? What theories, beliefs, and prior research findings. r.
This document provides an overview of research reports, including their purpose, types, and components. A research report communicates the purpose, methodology, findings, and conclusions of a research project. It has several key sections: an introduction that establishes the background and purpose of the research; a literature review that summarizes previous work on the topic; a methodology ...
A research report should normally be written in the third person and aoid use of pronouns like, 'I', 'Me', 'My' etc. 5. The report should facilitate the reader with systematic ...
7 components of Research Report - Free download as Powerpoint Presentation (.ppt / .pptx), PDF File (.pdf), Text File (.txt) or view presentation slides online. A research report is a reliable source to recount details about a conducted research and is most often considered to be a true testimony of all the work done to garner specificities of research.
Both GLP-1 and GIP belong to the incretin system that regulates hormone secretion in response to carbohydrate intake. 32 Although the effect of GIP has been found to be greatly attenuated in patients with type 2 diabetes, 33 subsequent research has shown that islet β-cell sensitivity to GIP may be restored with glycemic control. 34 Glucose ...
from $3.31 billion in 2022 to $4.57 billion in 2023—a 38% increase. The second-costliest type of crime was business e-mail compromise (BEC), with 21,489 complaints amounting to $2.9 billion in reported losses. Tech support scams, meanwhile, were the third-costliest type of crime tracked by IC3.
OCs are by far the most common type of stony meteorites arriving at Earth. OCs, ECs, and RCs are fragments of siliceous (S-type) asteroids that formed in the inner Solar System, in the same region as the rocky planets (31, 32).The Ru isotope signatures of NC meteorites (OC, EC, RC, and most NC irons) are less distinct from the Ru isotope composition of Earth ().
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