Defined question
The audience, selected record, source standard, intended output, and medical boundary.
Medical evidence map specimen
When similar trials answer different questions.
This fourteen page evidence map compares ARRIVE, ASCEND, and ASPREE, three randomized 2018 trials of daily aspirin for primary prevention. It preserves the populations, endpoint definitions, reporting scales, effect estimates, bleeding evidence, later record, and limits that govern any responsible comparison.
Public record only · No client involved · Not medical adviceDownload the complete specimen
The PDF contains six defined sections and linked primary sources.
The map is designed for inspection. A reader can move from the executive comparison to the trial profile, numeric result, qualification, and original public record.
The research problem
Primary prevention is a category, not a single population or outcome.
The three trials used the same daily aspirin dose and appeared in the same year. They did not enroll the same people or define the same cardiovascular and bleeding outcomes. ARRIVE also recorded a much lower event rate than expected. A useful map preserves those differences before it compares the numbers.
Inside the work
Contents of the fourteen page evidence map.
Executive map
The three trial populations, findings, and interpretive constraints in one view.
Population and endpoint crosswalk
Eligibility and outcome definitions kept distinct before numbers are compared.
Trial profiles
ARRIVE, ASCEND, and ASPREE reported with design, follow up, result, uncertainty, and author interpretation.
Currency and limits
Later evidence, guidance, absences, and questions outside the bounded record.
Linked source ledger
DOI, PMID, trial registration, source role, and direct inspection path.
The comparison in brief
Three trials that cannot be pooled by eye.
The abbreviated table below is an orientation, not a substitute for the report or a systematic synthesis.
| Trial | Population | Reported result | Constraint |
|---|---|---|---|
| ARRIVE | 12,546 adults selected for moderate estimated risk; diabetes excluded | Primary endpoint 4.29% with aspirin and 4.48% with placebo; HR 0.96 | Observed event rate was much lower than expected, so the intended moderate risk question was not resolved |
| ASCEND | 15,480 adults with diabetes and no evident cardiovascular disease | Serious vascular events 8.5% and 9.6%; rate ratio 0.88. Major bleeding 4.1% and 3.2%; rate ratio 1.29 | Absolute vascular benefit was largely counterbalanced by bleeding hazard |
| ASPREE | 19,114 community dwelling older adults without cardiovascular disease, dementia, or disability | Cardiovascular disease 10.7 and 11.3 per 1000 person years; HR 0.95. Major hemorrhage 8.6 and 6.2; HR 1.38 | Cardiovascular disease and hemorrhage were prespecified secondary endpoints |
Primary reports
The public record beneath the map.
The trial reports provide the design, eligibility, endpoint definitions, results, uncertainty, and author interpretation. Registries and later sources are linked inside the PDF.
Professional boundary
This demonstrates evidence organization, not clinical judgment.
The specimen is not a systematic review, guideline, diagnosis, or treatment recommendation. It does not tell any person whether to start, continue, or stop aspirin. A clinical or policy decision requires a question specific current review and qualified professional judgment.
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