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. 2012 Oct 17;2012(10):CD004398. doi: 10.1002/14651858.CD004398.pub3

Haas 2004.

Methods Study design: ITS
Participants Physicians
Clinical speciality: not clear
Level of training: fully trained
Setting/country: outpatient (e.g. ambulatory care provided by hospitals/specialists)/US
Interventions 2 PEMs are studied in this report: 1. The HERS published in 1998 and 2. The WHI, published on 17 July 2002. These clinical trials demonstrated that the risks associated with hormone therapy outweighed the benefits for women taking continuous oestrogen and progestin regimens
Outcomes 2 process outcomes:
  1. use of hormone therapy among postmenopausal women (before and after the publication of HERS)

  2. use of hormone therapy among postmenopausal women (before and after the publication of WHI)

Notes
Risk of bias
Bias Authors' judgement Support for judgement
Intervention independent of other changes ‐ ITS Unclear risk No information was provided
Shape of Intervention effect pre‐specified ‐ ITS Low risk Quote, pg. 184: "we designed our analysis to examine whether the use of hormone therapy has changed among postmenopausal women as a result of the publication of the results from HERS and the WHI. We were also interested in examining whether patterns of use differ by patient characteristics. Because HERS examined the outcomes of older women, we hypothesized that there would be earlier and more substantial declines in hormone therapy use among this group. We also expected that there would be variation in use by race or ethnicity because white women may have better access to new information. Finally, because the WHI study results were specific to women taking continuous estrogen plus progestin, we hypothesized that hormone use would be more stable among women who had had hysterectomies because such women typically take only estrogen and may believe that the findings do not apply to them"
Intervention unlikely to affect data collection ‐ ITS Low risk The interventions (HERS study; WHI Study) did not affect either the source or method of data collection
Blinding of outcome assessors (detection bias) ‐ ITS 
 All outcomes Low risk The outcome was objective
Incomplete outcome data (attrition bias) ‐ ITS 
 All outcomes Low risk The San Francisco mammography registry was used
Selective reporting (reporting bias) ‐ ITS Low risk All relevant outcomes in the methods section were reported in results section
Other bias ‐ ITS Low risk There was no evidence of other risks of bias