Looking for the Pony in the HERS Data

摘要: One of the great public health advances last century was development randomized, controlled clinical trial, which is designed to control for known and unknown differences in persons who take or do not medication (by use randomization), effects patient provider expectation double-blind placebo control). See p 917 The late Reuel A. Stallones fond teaching that trials are done during a narrow window opportunity when there enough evidence benefit justify time expense but so much it would be unethical deprive participants “active” treatment by assigning them placebo. This particularly difficult achieve has been many years, its demonstrated repeatedly epidemiological studies practice, thought leaders major medical organizations have already recommended widespread use. Such case with hormone replacement therapy (HRT) prevention heart disease. At beginning Heart Estrogen/progestin Replacement Study (HERS), secondary trial estrogen postmenopausal women disease, several experts opined this unnecessary at best worst, given consistency observational data, certainly looks very impressive meta-analysis, plethora potential cardioprotective mechanisms vivo vitro. It therefore more than bit shock HERS results showed no overall HRT completely unexpected early excess cardiovascular events.1 The reaction research community these one disbelief denial …