{"effect":{"id":"injection_site_reaction","name":"Injection site reaction","severity":"mild","description":"Redness, itching, swelling, or mild pain at the injection site. Usually mild. No clinical source on file states how long it lasts.","clinicalRates":{"low":0.03,"medium":0.04,"high":0.05},"clinicalRatesNote":"A fixed reference table dated 2026-04-12, not derived from this corpus and carrying no per-effect citation of its own — see `sources` on ?q=effect&id=<id> for what was recorded behind each effect. It reaches published numbers two ways. (1) As the sole clinical base for an effect with no eligible corpus rate point — exactly the effects whose pooled corpus estimate is null (corpusClinical here, rateBase.clinical.pooledEstimate on the per-effect endpoint); the predictor marks these isFallback: true. (2) Since 2026-08-28, as a dose-tier rescale ratio applied to the corpus's OWN pooled rate wherever that tier's pooled clinical records are mostly dose-untagged; isFallback stays false in that case, and the predictor's clinical.basis states both endpoints and the dose-tag denominator while clinical.pooledPercentage carries the corpus rate before any adjustment. Full per-source detail: rateBase.clinical via ?q=effect&id=<id>. WITHDRAWN 2026-09-03 (decision literature-fallback-clinical-rate-2026-08-28, option c) for emotional_blunting only: this table had no rate-stating source at all for it, so its clinicalRate fields are null here and its predictor track carries `available: false` with no percentage — see clinicalRatesWithdrawn on ?q=effect&id=emotional_blunting. RE-SOURCED 2026-09-03 (same decision, option b) for fatigue only: its three tier values are one figure, 0.11, from the FDA Wegovy prescribing information revised 06/2026 (Table 3: fatigue incl. asthenia 11% on 2.4 mg, N=2,116, vs 5% placebo, N=1,261; URL in its sources) — the label reports no per-dose-tier rate, so no gradient is published for it, and it is a semaglutide figure applied at every dose tier regardless of molecule, as this whole table is. RE-SOURCED 2026-09-04 (decision pancreatitis-hairloss-dizziness-triple-derivation-2026-09-03) for hair_loss, dizziness and pancreatitis: their 2026-04-12 triples (1–3%, 2–5%, 0.5–1.2%) had no recorded derivation and their cited trial pages state no such figures; each is now one value at every tier from the same FDA Wegovy label — hair_loss 0.03 (Table 3: 3% on 2.4 mg, N=2,116, vs 1% placebo), dizziness 0.08 (Table 3: 8% vs 4%), and pancreatitis 0.002, which is NOT a proportion of patients like every other value in this table but the label's incidence RATE of 0.2 acute-pancreatitis cases per 100 patient-years of Wegovy exposure (4 adjudicated cases vs 1 on placebo, section 5) — read it with that unit. Figures served before 2026-09-04 for these three effects should not be cited.","confidenceNote":"`sourceDiversity` (formerly `confidence`, kept as a deprecated alias with the same value) measures SOURCE DIVERSITY, not precision: it is derived only from distinctSources (≤1 very_low, ≤3 low, ≤9 moderate, ≤24 high, ≥25 very_high) and is computed without reference to the confidence interval. It can read `moderate` on an estimate whose interval spans nearly the whole range — always read ciLowPct/ciHighPct alongside it, and treat a wide interval as the binding statement about how well we know the rate. The converse does NOT hold, and until 2026-09-11 nothing here said so: a NARROW interval is not evidence of a well-known rate. τ² (the between-study heterogeneity term) is 0 by construction when a single source entry contributes, so such an estimate publishes that one study's sampling interval and nothing else — read `intervalBasis` on every pooled block (`sampling_only_single_source` vs `sampling_plus_between_study`, with `intervalNote`/`intervalNoteNl` spelling it out) before reading a tight range as precision.","samplingNote":"Registry sampling bias, disclosed 2026-09-10 and corrected 2026-09-16: registry rows collected before 2026-09-10 through the rotation path were capped at the five highest-percentage arm rows per trial, which selects on the rate being measured (19 of the 25 trials with stored registry rows at the time; the six pinned pivotal trials — SURMOUNT-1, SELECT, STEP 1, STEP 2, SURPASS-CVOT, retatrutide phase 2 — were never affected). The collector was fixed 2026-09-10 and the 19 trials were re-collected in full between 2026-09-10 and 2026-09-16 (every tracked non-placebo arm row the registry posts is stored, verified against the live registry on 2026-09-16), so each study's entry in a pooled estimate is now the mean of every arm the registry posts for that term, not of its five highest. Method, per-trial measurements and the correction record: §4 Limitations and correction-log items 25 and 32 of the published methodology, https://github.com/saurabhgoyal75/magistra-predictor/blob/main/preprint/magistra-methodology.md.","modifiers":{"femaleFactor":1.1,"ageFactor65plus":1,"giHistoryFactor":1,"diabetesFactor":1,"firstMonthFactor":1.5},"modifiersNote":"Odds ratios hand-coded at the 2026-04-12 seed with no per-modifier citation recorded — treat each as an expert-coded prior, not a sourced estimate. The empirical estimator runs daily and 12 of the 15 tracked effects now clear its 10-eligible-point minimum, but zero empirical modifiers have been applied and none can be under the current extraction: all 1,111 eligible rate points behind those fits carry sex 'unspecified' and none carries an age band including 65 (measured 2026-09-18), so both fitted covariates are constant and every coefficient fits at 0. Model config is v5 (2026-09-12); its post-seed changes re-sourced four static base rates (v2, 2026-09-04) and aligned narrative fields with their sources (v3, v5). See ?q=help for the full methodology note.","reportingFrequency":{"mentions":6,"distinctReports":26,"sharePct":23.1,"platforms":["reddit.com","drugs.com"],"note":"Share of distinct community reports (one row per source URL) that mention this effect. Counts only reports hosted on the community platform itself, and — corrected 2026-08-29 — only Reddit posts from the GLP-1, weight-management and diabetes subreddits we collect from: the scraper's subreddit restriction was not holding, and 159 of the previous 185 reports were posts matched on a symptom word in unrelated communities (r/gallbladders, r/AskDocs, r/pregnant). News-aggregator results are excluded, see platforms. The remaining base is small and cannot currently grow (Reddit has blocked our collector since 2026-05-28), so read every share with its distinctReports denominator. Not an incidence rate; not comparable to clinicalRates."},"userReportedSeverity":"Generally mild. Users describe small red bumps or slight itching that resolve within 1-2 days. Rotating injection sites helps. Rarely a reason to stop treatment.","onsetDays":"Not stated by any clinical source on file.","durationWeeks":"Not stated by any clinical source on file.","managementTip":"Rotate injection sites (thigh, abdomen, upper arm). Let the pen reach room temperature before injecting. Apply a cold compress if the area is irritated.","sources":[{"name":"STEP-1 Trial (Wilding et al., NEJM 2021)","type":"clinical","url":"https://www.nejm.org/doi/full/10.1056/NEJMoa2032183","weight":0.3},{"name":"SURMOUNT-2 Trial (Garvey et al., Lancet 2023)","type":"clinical","url":"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01200-X/fulltext","weight":0.3},{"name":"Diabetes forum injection site discussions (2024-2026)","type":"user_report","weight":0.4}]},"dataPointCount":48,"rateBase":{"note":"Only externally citable, non-duplicated rates support an estimate. Shares of spontaneous adverse-event reports (FAERS) are reported separately — they are not incidence. A source marked rateKind: \"serious_ae\" states a rate from a trial registry's SERIOUS adverse-events table for a term posted in no other table of the same arm — a real stated figure, but a floor on all-cause incidence, since the registry lists non-serious events only above the trial's reporting threshold.","clinical":{"statedRates":4,"distinctSources":2,"sourceEntries":2,"pooledEstimate":{"ratePct":4.5,"ciLowPct":0,"ciHighPct":53,"statedRates":4,"distinctSources":2,"sourceEntries":2,"seriousAeSources":0,"rateKindNote":"","rateKindNoteNl":"","intervalBasis":"sampling_plus_between_study","intervalNote":"","intervalNoteNl":"","confidence":"low","sourceDiversity":"low"},"confidenceNote":"`sourceDiversity` (formerly `confidence`, kept as a deprecated alias with the same value) measures SOURCE DIVERSITY, not precision: it is derived only from distinctSources (≤1 very_low, ≤3 low, ≤9 moderate, ≤24 high, ≥25 very_high) and is computed without reference to the confidence interval. It can read `moderate` on an estimate whose interval spans nearly the whole range — always read ciLowPct/ciHighPct alongside it, and treat a wide interval as the binding statement about how well we know the rate. The converse does NOT hold, and until 2026-09-11 nothing here said so: a NARROW interval is not evidence of a well-known rate. τ² (the between-study heterogeneity term) is 0 by construction when a single source entry contributes, so such an estimate publishes that one study's sampling interval and nothing else — read `intervalBasis` on every pooled block (`sampling_only_single_source` vs `sampling_plus_between_study`, with `intervalNote`/`intervalNoteNl` spelling it out) before reading a tight range as precision.","samplingNote":"Registry sampling bias, disclosed 2026-09-10 and corrected 2026-09-16: registry rows collected before 2026-09-10 through the rotation path were capped at the five highest-percentage arm rows per trial, which selects on the rate being measured (19 of the 25 trials with stored registry rows at the time; the six pinned pivotal trials — SURMOUNT-1, SELECT, STEP 1, STEP 2, SURPASS-CVOT, retatrutide phase 2 — were never affected). The collector was fixed 2026-09-10 and the 19 trials were re-collected in full between 2026-09-10 and 2026-09-16 (every tracked non-placebo arm row the registry posts is stored, verified against the live registry on 2026-09-16), so each study's entry in a pooled estimate is now the mean of every arm the registry posts for that term, not of its five highest. Method, per-trial measurements and the correction record: §4 Limitations and correction-log items 25 and 32 of the published methodology, https://github.com/saurabhgoyal75/magistra-predictor/blob/main/preprint/magistra-methodology.md.","seriousAeSources":0,"drugMix":[{"drug":"tirzepatide","statedRates":3,"distinctStudies":1,"sourceEntries":1,"pooledWeightPct":98.9},{"drug":"dulaglutide","statedRates":1,"distinctStudies":1,"sourceEntries":1,"pooledWeightPct":1.1}],"drugMixNote":"Which molecules the rows behind this estimate describe. statedRates counts eligible rate rows — the same n published beside the estimate — and pooledWeightPct is the share of the weighted mean that drug's collapsed source entries actually carry, after one-entry-per-source collapsing and sample-size weighting. The two diverge widely: a drug can hold most of the rows and little of the weight when its rows are many small arms of a few trials. Read pooledWeightPct for what moves the percentage and statedRates for what the n is made of. Per-drug distinctStudies can sum above this estimate's own distinctSources — a trial with a comparator arm posts rows under two molecules and counts once under each. The drug is the one the row's own arm or source names; \"(unlabelled)\" is a row whose source names no molecule.","sources":[{"name":"ClinicalTrials.gov results — Effects of GLP1-RA on Ectopic Fat Deposition in Chronic Kidn — local injection site erythema","url":"https://clinicaltrials.gov/study/NCT05254418#adverse-events","rate":0.143,"sampleSize":7,"rateKind":"incidence"},{"name":"ClinicalTrials.gov results — A Study of Tirzepatide (LY3298176) in Participants With Obes — Injection site reaction","url":"https://clinicaltrials.gov/study/NCT04184622#adverse-events","rate":0.044,"sampleSize":636,"rateKind":"incidence"}],"excluded":{"spontaneous_report_share":9,"no_rate":5,"seed_unverified":6},"usesPublishedFallback":false},"community":{"statedRates":0,"distinctSources":0,"sourceEntries":0,"excluded":{"seed_unverified":4,"no_rate":20},"usesPublishedFallback":true},"spontaneousReportShares":[{"source":"FDA FAERS — tirzepatide — INJECTION SITE PAIN","url":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"tirzepatide\"","shareOfReports":0.101,"reports":12325,"totalReports":122084},{"source":"FDA FAERS — tirzepatide — INJECTION SITE HAEMORRHAGE","url":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"tirzepatide\"","shareOfReports":0.039,"reports":4746,"totalReports":122084},{"source":"FDA FAERS — tirzepatide — INJECTION SITE ERYTHEMA","url":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"tirzepatide\"","shareOfReports":0.035,"reports":4295,"totalReports":122084},{"source":"FDA FAERS — dulaglutide — INJECTION SITE PAIN","url":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"dulaglutide\"","shareOfReports":0.096,"reports":9796,"totalReports":101618},{"source":"FDA FAERS — dulaglutide — INJECTION SITE HAEMORRHAGE","url":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"dulaglutide\"","shareOfReports":0.031,"reports":3132,"totalReports":101618},{"source":"FDA FAERS — exenatide — INJECTION SITE PAIN","url":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"exenatide\"","shareOfReports":0.021,"reports":2023,"totalReports":94688},{"source":"FDA FAERS — exenatide — INJECTION SITE BRUISING","url":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"exenatide\"","shareOfReports":0.019,"reports":1843,"totalReports":94688},{"source":"FDA FAERS — exenatide — INJECTION SITE HAEMORRHAGE","url":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"exenatide\"","shareOfReports":0.019,"reports":1809,"totalReports":94688},{"source":"FDA FAERS — lixisenatide — INJECTION SITE PAIN","url":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"lixisenatide\"","shareOfReports":0.022,"reports":73,"totalReports":3364}]},"dataPointsBySource":{"clinical":15,"regulatory":9,"user_report":21,"news":3},"sampleDataPoints":[{"sourceName":"FDA FAERS — tirzepatide — INJECTION SITE PAIN","sourceType":"regulatory","sourceUrl":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"tirzepatide\"","extractedRate":0.101,"extractedSeverity":null,"extractedSampleSize":122084,"extractionConfidence":"high","scrapedAt":"2026-04-07T04:00:55.914Z"},{"sourceName":"FDA FAERS — tirzepatide — INJECTION SITE HAEMORRHAGE","sourceType":"regulatory","sourceUrl":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"tirzepatide\"","extractedRate":0.039,"extractedSeverity":null,"extractedSampleSize":122084,"extractionConfidence":"high","scrapedAt":"2026-04-07T04:00:58.682Z"},{"sourceName":"FDA FAERS — tirzepatide — INJECTION SITE ERYTHEMA","sourceType":"regulatory","sourceUrl":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"tirzepatide\"","extractedRate":0.035,"extractedSeverity":null,"extractedSampleSize":122084,"extractionConfidence":"high","scrapedAt":"2026-04-07T04:00:58.865Z"},{"sourceName":"FDA FAERS — dulaglutide — INJECTION SITE PAIN","sourceType":"regulatory","sourceUrl":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"dulaglutide\"","extractedRate":0.096,"extractedSeverity":null,"extractedSampleSize":101618,"extractionConfidence":"high","scrapedAt":"2026-04-12T10:18:53.055Z"},{"sourceName":"FDA FAERS — dulaglutide — INJECTION SITE HAEMORRHAGE","sourceType":"regulatory","sourceUrl":"https://api.fda.gov/drug/event.json?search=patient.drug.openfda.generic_name:\"dulaglutide\"","extractedRate":0.031,"extractedSeverity":null,"extractedSampleSize":101618,"extractionConfidence":"high","scrapedAt":"2026-04-12T10:18:55.019Z"}],"lastUpdated":"2026-09-19"}