Week 2: WHI Flashcards

1
Q

Interpretation of WHI data

A
  • can’t be extrapolated to the typical population using HT. Avg. age was 63 at screening.
  • Majority of women initiate HT to alleviate menopausal symptoms
  • Women with severe menopausal symptoms were excluded from trial
  • 75% of HT users initiate therapy within 5 years of menopause; mean age of menopause, 51 years
  • Menopausal age of patients in WHI has not yet been reported
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2
Q

Comparison of WHI results with observational studies

A

AGREE
-increase in VTE with oral HRT
-increase in Breast cancer diagnosis with HRT. (1.2x greater risk)
-Increase CVA when started in older women
-decrease hip fracture
-decrease in colon cancer
DISAGREE
-increase in CHD
-increase in dementia only >age70 in first year of HRT (found to be decreased with ERT in cohort study)
-E alone protective in breast cancer

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3
Q

Problems in WHI study

A
  • HTN not controlled
  • high rates of unblinding in the HRT vs placebo arm of study
  • global index created for the study not validated and significance of assigning equal weights to various conditions unexamined
  • statistical analyses: confusion in reporting type of Confidence interval used
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