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. 2004 Oct 18;2004(4):CD002978. doi: 10.1002/14651858.CD002978.pub2

Notelovitz 2000a.

Methods Study Design: parallel, double‐blind, multicentre, placebo‐controlled, randomised clinical trial 
 Randomisation: block randomisation within each centre 
 Number of Centres: 15 
 Duration of Trial: 3 months 
 Power Calculations: yes (based on moderate to severe hot flush outcome) 
 Number of women randomised: 333 into 1 of 5 treatment groups 
 Number of women analysed: 280 for moderate/severe hot flushes & 324 for hot flush weekly weighted score 
 Intention‐to‐treat analysis: no for moderate/severe hot flushes, yes for hot flush weekly weighted score. 
 Losses to follow‐up/withdrawals from treatment: 53/333 = 16% for moderate/severe hot flushes and 4/333 = 1.2% for hot flush weekly weighted score 
 Compliance: not stated 
 Source of Funding: supported by grants to participating institutions and Novo Nordisk Pharmaceuticals Inc
Participants Menopausal status: peri‐ and post‐menopausal 
 Age: mean 54.12 ± 4.14 years (mean ± SD) (range 40 to 60 years) 
 Location: USA 
 Ethnicity: Race (n, %) in placebo, 0.25 mg E2, 0.5 mg E2, 1.0 mg E2, 2.0 mg E2 respectively: 
 White ‐ 60 (91%), 62 (91%), 61 (95%), 57 (85%), 62 (91%) 
 Black ‐ 3 (5%), 3 (4%), 2 (3%), 5 (7%), 1 (1%) 
 Hispanic ‐ 1 (2%), 2 (3%), 1 (2%), 4 (6%), 3 (4%) 
 Asian/Pacific ‐ 2 (3%), 0 (0%), 0 (0%), 1 (1%), 2 (3%) 
 Other ‐ 0 (0%), 1 (1%), 0 (0%), 0 (0%), 0 (0%) 
 Source: study population was obtained from the investigators´ sites or through local advertising (i.e. a mixture of clinical and general population) 
 Inclusion Criteria: menopause symptoms persisting for more than 6 months, healthy menopausal women with an intact uterus, 40‐60 years old, at least 56 moderate‐severe hot flushes/week, at least 6 months amenorrhoea, E2 levels <= 20pg/mL, FSH >= 50 IU/L 
 Exclusion Criteria: history of endometrial hyperplasia, abnormal bleeding of unknown origin, endometrial thickness at least 5mm, history of estrogen‐dependent tumours, gallbladder, liver kidney or endocrine diseases except controlled thyroid disease, venous thromboembolism, cerebrovascular accidents, myocardial infarction or ischaemic heart disease, history of severe headache or migraines, high blood pressure, alcohol or drug abuse, smoking > 15 cigarettes/day, weight increased more than 20% over ideal body weight, use of steroid hormones/drugs known to influence estrogen metabolism & use of HRT within 2 months prior to randomisation 
 Confirmation of Ovarian Failure: at least 6 months amenorrhoea, E2 levels <= 20pg/mL, FSH >= 50 IU/L 
 Baseline Equality: matched for age, time of amenorrhoea, weight, baseline hot flush symptoms 
 Baseline Symptoms: At least 56, with 72 ± 21 (mean ± SD) moderate‐severe hot flushes/week & mean hot flush weekly weighted score 183 ± 61(mean ± SD).
Interventions Rx1 (E, low dose): micronized 17b‐oestradiol 0.25 mg/day 
 Rx2 (E, low dose): micronized 17b‐oestradiol 0.5 mg/day 
 Rx3 (E, moderate dose): micronized 17b‐oestradiol 1.0 mg/day 
 Rx4 (E, high dose): micronized 17b‐oestradiol 2.0 mg/day 
 Rx5: placebo 
 The HRT and placebo preparations were identical in appearance 
 Co‐interventions: none reported
Outcomes 1. Weekly hot flush frequency 
 2. Hot flush weekly weighted score 
 3. Withdrawals from therapy 
 4. Adverse event frequency
Notes The author was contacted and supplied further information.
Risk of bias
Bias Authors' judgement Support for judgement
Allocation concealment? Low risk A ‐ Adequate