In 2002, the publication of the results of Women's Health Initiative (WHI) fundamentally changed how hormone replacement therapy (HRT) was used in the U.S. The study was halted early because of the finding of increased risk of heart attack, stroke, breast cancer and clots from HRT use. The reaction was a dramatic decrease in the number of women using HRT. This story reports on a study published in this week's Circulation showing that using estrogen in the form of a skin patch may not cause the increased risk of blood clots that is associated with the use of hormones in the pill form.
This story does an excellent job of explaining the current study, describing other studies that have shown similar results, and outlining some of the problems with drawing firm conclusions from an observational trial. Furthermore, the story does an adequate job of describing the availability, novelty and harms of hormone therapy.
Because the story quotes multiple, independent experts, the reader can assume the story does not rely on a press release as the sole source of information. The story did an especially good job of noting possible conflicts of interest in researchers.
However, the story should have quantified the risk of blood clots in absolute terms, not relative terms. The story states that "women who took hormone pills were 4 times as likely to suffer a serious blood clot." Four times higher than what? The story could have provided more context for the reader on these numbers by giving the actual risk of clotting from the pills compared to the patch.
The story does not mention costs of any of the types of hormone therapy, an important piece of information since they are often not covered well by insurance.
Because this story reports on the risks of clots from hormone therapy, this criteria will be judged against how well the story quantified the risks, not the benefits, of the treatment. The story should have quantified the risk in absolute terms, not relative terms. The story states that "women who took hormone pills were 4 times as likely to suffer a serious blood clot." 4 times higher than what? The story could have provided more context for the reader on these numbers by giving the actual risk of clotting from the pills compared to the patch.
The story mentions blood clots, stroke and breast cancer as potential harms of hormone therapy.
The story does an excellent job of explaining the current study, describing other studies that have shown similar results, and outlining some of the problems with drawing firm conclusions from an observational trial.
The story does not exaggerate the seriousness of blood clots. However, the story may mislead women into thinking they are more common than they are by describing them as "one of the most common health risks associated with hormones." No sense of absolute risk is given in the general population of women or among women taking hormone therapy. Blood clots are still very rare with hormones, occuring in fewer than 25 women per 10,000. Nonetheless, we'll give the story the benefit of the doubt on this criterion.
The story quotes several independent experts who have differing views on the value of the new information. It did an especially good job of noting conflicts of interest where they existed.
The story mentions estrogen in the form of pills, patches, rings and gels.
The story explains that the patches are popular in Europe but not used as widely in the U.S.
The story mentions that millions of women use hormones to treat menopausal symptoms, so clearly they are not new.
Because the story quotes multiple, independent experts, the reader can assume the story does not rely on a press release as the sole source of information.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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