In 2002, “Risks and benefits of estrogen plus progestin in healthy postmenopausal women” was the first paper published from the Women’s Health Initiative (WHI) study. Unlike previous observational studies, the data were suggestive of harm. The paper was released at a press conference and the media told the public that users of postmenopausal hormone replacement therapy were ‘29% more likely to suffer coronary heart disease, 26% more likely to contract breast cancer and 41% more likely to suffer a stroke’. That the absolute numbers were seven more cases of heart disease, eight more strokes and eight more breast cancers per 10,000 women was lost in translation.
The effect on clinicians and their management of postmenopausal women was massive. Many women ceased hormone therapy, many more never started and the adverse consequences of those decisions on their cardiovascular health, bone health and quality of life have been discussed elsewhere.
Now a new paper (The evidence base for HRT: what can we believe?) has been published which raises questions about due process surrounding data evaluation, writing, author approval and publication of the original WHI paper. It seems not all principal investigators were consulted during the data evaluation and writing phases. There may have been protocol violations and the paper was prepared and published prior to review by all authors.
Baber R. What is scientific truth? Climacteric, 2017 Vol. 20, No. 2, 83-84 http://dx.doi.org/10.1080/13697137.2017.1295220
Content updated 15 March 2017