Structured Reviews and Meta Analysis

After a number of studies are completed, whether cohort studies or initial small RCTs, these are often reviewed and summarized in publications called structured reviews. Occasionally, data from a series of studies are combined using a statistical technique called meta-analysis, which allows increased statistical power to determine the weight of evidence from a series of studies. The use of HRT was greatly increased during the 1990s based on a number of case-control and cohort studies and on three meta-analysis studies that further suggested that HRT was protective against CHD (Pettiti, 1998).

In 1991, an editorial in the New England Journal of Medicine concluded that "a consensus of epidemiologic reports has demonstrated that women who are given postmenopausal estrogen therapy have a reduction of about 40% to 50% in the risk of ischemic heart disease as compared with women who do not receive such therapy" (Goldman and Tosteson, 1991). HRT became a de facto standard for postmenopausal women through the 1990s.



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