Hersh 2004.
| Methods | Study design: ITS | |
| Participants | Physicians Clinical speciality: not clear Level of training: fully trained Setting/country: not clear/US |
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| Interventions | 3 PEMs were studied in this report: 1. The HERS (August 1998), 2. HERS follow‐up (HERS II ‐ July 2002), and 3. The WHI (17 July 2002). HERS and HERS II concluded that postmenopausal hormone therapy with combination PO oestrogen/progestin offered no cardiovascular disease benefit among women with established disease. The oestrogen plus progestin trial of the WHI demonstrated that hormone therapy with an oestrogen/progestin combination caused increased risk of breast cancer and cardiovascular disease in postmenopausal women | |
| Outcomes | 1 process outcome: total number of prescriptions per year (before and after the publication of HERS ‐ August 1998) | |
| Notes | We looked at the combined effect of the 3 PEMs because of a lack of data to look at them separately. In this case, the 2 PEMs studied had similar characteristics, and we considered them as a whole (i.e. 1 PEM) | |
| 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 | Unclear risk | Quote, pg. 48: "national trends in hormone therapy use since 1995 have not been reported, and the impact of recent evidence on hormone therapy prescriptions in subsequent months is unknown. Our objective was to describe these trends using national data on hormone therapy prescriptions and patient visits to physicians during which hormone therapy was prescribed" |
| Intervention unlikely to affect data collection ‐ ITS | Low risk | The interventions (HERS study; HERS II; 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 | Data come from 2 nationally representative databases |
| 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 |