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Hormone Therapy
Making Decisions in the Face of Uncertainty
Arch Intern Med. 2004;164:2308-2312.
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INTRODUCTION
In 1994, we concluded in a decision analysis that women who used estrogen therapy from age 50 to 75 years would improve their quality of life.1 Almost 10 years later, we have new evidence on the risk and protective factors associated with hormone therapy (HT) from 4 randomized controlled trials and a more sophisticated decision model presented in the ARCHIVES2 that allows for a more complete balancing of the risks and benefits of hormone use. Despite these gains, important uncertainties remain regarding issues that are pivotal to understanding the role of HT, suggesting the critical need for more research, particularly with regard to the impact of HT on quality of life.
NEW EVIDENCE
Findings from 4 recent randomized controlled trials argue against any benefit of HT for prevention of coronary heart disease: (1) the Women’s Estrogen for Stroke Trial,3 which assessed the use of estrogen therapy alone (1 mg/d of estradiol-17 . . . [Full Text of this Article]
MODELING ASSUMPTIONS
Coronary Heart Disease Stroke Breast Cancer Alzheimer Disease
A NEW DECISION MODEL
PRIORITIES FOR RESEARCH
GUIDANCE PENDING FURTHER EVIDENCE
AUTHOR INFORMATION
Herbert B. Peterson, MD;
Stephen B. Thacker, MD, MSc;
Phaedra S. Corso, PhD;
Polly A. Marchbanks, PhD;
Jeffrey P. Koplan, MD, MPH
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