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Re: WHI & HRTFrom: Zach Newton (zbnewton@bellsouth.net)Tue Jul 9 19:19:51 2002
The WHI release certainly represents evidenced based medicine. The initial take across the board of media, press releases from authorities, carefully crafted statements from pharmaceuticals is a tsunami of rush to judgment against a standard developed over decades of intensive and extensive study. No one knows how this will sort out. But, it is disconcerting that the terms "risk" and "safe" are tossed out as absolutes. There is in the awareness of all here the matters of assessment, value assignment and decision analysis that must be applied. My response to phone calls is recommendation to come in for conference to discuss on an individualized basis. A fair representation of options are discussed, including no medication (not unreasonable). In role reversal, I would be taking ERT/HRT tomorrow, absent a compelling reason not to do so. I do not find the WHI reason to be, in itself, a compelling reason to abandon as maintenance for women without known cardiovascular disease. The issue of breast cancer raised by the study does not address the data that demonstrate lower death rate from breast cancer among users vs non-users. ERT/HRT is not an option available to most Russians, as an example. Demographic comparisons of death rates and morbidity would be of interest.
-- Zach Newton Z. B. Newton, III, M.D. Atlanta/Gyn
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